Medicare Claims Processing Manual (Pub. 100-04), Ch. 17 § 80.11
Requirement for Providing Route of Administration Codes for
80.11 - Requirement for Providing Route of Administration Codes for
Erythropoiesis Stimulating Agents (ESAs)
(Rev. 1212; Issued: 03-30-07; Effective: 01-01-07; Implementation: 06-29-07)
Patients with end stage renal disease (ESRD) receiving administrations of erythropoiesis
stimulating agents (ESA), such as epoetin alfa (EPO) and Darbepoetin alfa (Aranesp) for
the treatment of anemia may receive intravenous administration or subcutaneous
administrations of the ESA.
Effective for claims submitted on or after February 1, 2007 with dates of services on or
after January 1, 2007, all providers billing for injections of ESA for ESRD beneficiaries
are encouraged to include the modifier JA on the claim to indicate an intravenous
administration or modifier JB to indicate a subcutaneous administration. All providers
billing for injections of ESAs for ESRD beneficiaries will be required to include route of
administration when claims processing system changes are completed. Renal dialysis
facilities claim including charges for administrations of the ESA by both methods must
report separate lines to identify the number of administration provided using each
method.