Epoetin Alfa (EPO) Provided in the Hospital Outpatient

60.4.4.2 - Epoetin Alfa (EPO) Provided in the Hospital Outpatient Departments (Rev. 2582, Issued: 11-02-12, Effective: 04-01-13, Implementation: 04-01-13) When ESRD patients come to the hospital for an unscheduled or emergency dialysis treatment they may also require the administration of EPO. Effective January 1, 2005, EPO will be paid based on the ASP Pricing File. Hospitals use type of bill 13X (or 85X for Critical Access Hospitals) and report charges under the respective revenue code 0634 for EPO less than 10,000 units and revenue code 0635 for EPO over 10,000 units. Hospitals report the drug units based on the units defined in the HCPCS description. Hospitals do not report value code 68 for units of EPO. Value code 49 must be reported with the hematocrit value for the hospital outpatient visits prior to January 1, 2006, and for all claims with dates of service on or after January 1, 2008.