Pharmacy Question for the Week of May 20, 2019

Question:

What are the criteria points for EPO coverage regarding anemia patients with chronic renal failure?

Answer:

Erythropoietin (EPO) is covered for the treatment of anemia for patients with chronic renal failure who are on dialysis when one of the following are true.

It is administered in the renal dialysis facility
Or EPO is self-administered in the home by any dialysis patient (or patient caregiver) who is determined competent to use the drug and meets the other conditions specified in the Medicare Benefit Policy Manual.

Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

CPT is a registered trademark of the American Medical Association.

Pharmacy Question for the Week of May 20, 2019

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