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Thread: Epogen/Procrit/Aranesp

  1. #1

    Lightbulb Epogen/Procrit/Aranesp

    AAPC: Back to School
    Does anyone have any suggestins in order to ensure that our doctors are providing us with coverable diagnosis? We are considering creating a specific ordering form. Has anyone tried this approach? If so, please provide any helpful ideas that you may have. Thanks a bunch!!!!

  2. #2


    I hope this helps. At our facility the Aranesp will only get paid if certain rules apply. The medication is very expensive and I beleive these came from CMS.
    In order to get paid you must have one of these anemia codes:
    Anemia of chronic kidney disease 285.21
    Chronic kidney disease must be Stage 3,4,5 addition code and must be coded.If mentioned in the chart the pt is on chronic dialysis ICD-9 assumes this to be ESRD per the index.

    anemia due to chemo 284.89
    E-code E933.1

    The anemia codes must be the primary diagnosis

    Hope this helps
    Sharon Ruiz RHIT, CPC, CCS-P
    President Elect MBS Chapter

  3. #3
    Join Date
    Apr 2007


    Go into http://www.procritline.com/index.jsp. This web site will tell you the codes you need to use & the guidelines. Hope this helps

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