Question:
Do erythropoiesis-stimulating agents (ESAs) qualify as highly complex drugs?
Answer:
It is generally accepted by all payers—Medicare as well as commercial insurers— that erythropoiesis-stimulating agents (ESAs) do not qualify as highly complex drugs, and therefore the IV push should be billed with 96374 (or 96375 if secondary) and not as a chemotherapy administration.
This question was answered in our Coding Essentials for Infusion & Injection Therapy Services. For more hot topics relating to infusion services, please visit our store or call us at 1.800.252.1578, ext. 2.
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