Payment for Darbepoetin Alfa (Aranesp) in the Hospital

60.4.6.5 - Payment for Darbepoetin Alfa (Aranesp) in the Hospital Outpatient Department (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 Aranesp. For patients with ESRD who are on a regular course of dialysis, Aranesp administered in a hospital outpatient department is paid the MMA Drug Pricing File rate. Effective January 1, 2005, Aranesp will be paid based on the ASP Pricing File. Hospitals use bill type 13X (or 85X for Critical Access Hospitals) and report charges under revenue code 0636. The total number of units as a multiple of 1mcg is placed in the unit field. 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.