Medicare Claims Processing Manual (Pub. 100-04), Ch. 17 § 80.11

Requirement for Providing Route of Administration Codes for

Last amended: 2007Year: 2007Length: 166 wordsOfficial source
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.
Medicare Claims Processing Manual (Pub. 100-04), Ch. 17 § 80.11: Requirement for Providing Route of Administration Codes for | Justis AI