20160831 - FREE Code Books with Exam Prep Packages | Learn More

AAPC - August DL Sale: 50% OFF
Results 1 to 7 of 7

Thread: EA, EB, EC Modifiers

  1. #1

    Question EA, EB, EC Modifiers

    The new modifiers EA, EB & EC go into effect April 7. I am still trying to understand when and how to use these modifiers. Does anyone know of where I can get information on this? My understanding is that we use these modifiers only when we code J0881 and J0885, and ESRD is not the diagnosis for the patient. Then we have to use EA for anemia, chemo-induced; EB anemia, radio-induced; or EC anemia, non chemo/radio. If this is correct, then that is an easy way to explain it to our other coders.

    Thanks so much!
    Last edited by aglen; 04-01-2008 at 11:02 AM.

  2. #2
    Join Date
    Apr 2007
    Location
    Bettendorf, Iowa
    Posts
    127

    Wink

    Coding EPO's is confusing no matter what. Its always a challenge since policies are constantly changing and you need to consider NCD's and LCD's. Our medicare carrier is WPS and their website has been great with helping out with this.

    We primarily use aranesp J0881, but we do give procrit occasionally.

    If a patient has a diagnosis of renal failure we use the EC modifier. If the patient is on chemo (last tx within 3 months) we use EA.

    Double check with your local carrier and make sure you are meeting all other requirements for giving EPO's, it can be tricky.

  3. #3

    Default

    I post charges for our CKD clinic. We give Procrit to pre-dialysis patients at this units. One site that I have found helpful is http://www.procritline.com/ This website has links for each state. The modifiers are EA: ESA, anemia, chemo-induced; EB: ESA, anemia, radio-induced; and EC: ESA, anemia, non-chemo/radio. I'm sure that you've seen that you now have to report the HgB or HCT as well. You continue to use the EJ modifier to report subsequent administrations of ESAs. Non-ESRD claims that do not report one of the three modifiers will be returned. And any claim not reporting the most recent HCT or HgB will also be returned. We've been doing this since January. We have had some problems with Humana. We've had several of those claims returned. I think that they also want the creatinine to be reported. We're sorting that out right now.

    I hope this helps!

  4. #4

    Default

    http://www.cms.hhs.gov/Transmittals/...tNumPerPage=10

    Go to the above and there are attached Transmittals that i found very helpful. I post the Modifiers and H&H levels for our chemotherapy infusion center.

    Danielle

  5. #5
    Join Date
    Apr 2007
    Location
    Malone
    Posts
    359

    Default Modifiers

    Heather Winters, CPC, CFPC

  6. #6
    Join Date
    Apr 2007
    Posts
    93

    Default

    I post charges for CKD patients on Procrit (J0885) for our Nephrology office. We use the EC modifier on all medicare & medicare managed care patients. And yes, don't forget to put the hgb & hct! Also, are you reporting the PQRI measures when these patients are seen by the doctor & also have a Procrit injection??

  7. #7

    Default

    It's a nightmare, we also use WPS as our local carrier so their website is pretty informative. One thing I still don't understand is why do we have to use 285.9 which is an unspecified code when all along we've been using 285.21 with CKD or 285.22 w/neoplasm related?????

Similar Threads

  1. Modifiers
    By ryleequigley@yahoo.com in forum General Discussion
    Replies: 2
    Last Post: 03-17-2015, 09:51 AM
  2. Two Modifiers, Which goes first
    By Candice_Fenildo in forum Modifiers
    Replies: 3
    Last Post: 12-27-2013, 03:11 PM
  3. Modifiers -51 and -25
    By hthompson in forum Modifiers
    Replies: 5
    Last Post: 11-02-2011, 12:11 PM
  4. Q modifiers
    By PLAIDMAN in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 01-27-2010, 05:01 AM
  5. IR modifiers
    By carriebeth in forum Interventional Radiology
    Replies: 1
    Last Post: 06-11-2009, 11:44 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.