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US · guidance

CMS Pub. 100-04, ch. 17, § 80.10

Hospitals Billing for Epoetin Alfa (EPO) and Darbepoetin Alfa

activein force · 2026-08-25 – presentas-observed

(Aranesp) for Non-ESRD Patients

(Rev. 1412, Issued: 01-11-08, Effective: 01-01-08, Implementation: 04-07-08)

NOTE: For EPO and Aranesp billing instructions for beneficiaries with ESRD, see the

Claims Processing Manual, Chapter 8, sections 60.4 and 60.7.

For patients with chronic renal failure who are not yet on a regular course of dialysis,

EPO and Aranesp administered in a hospital and billed as an outpatient service on type of

bill 13x or inpatient Part B bill type 12x are paid under the Outpatient Prospective

Payment System (OPPS). Non-OPPS hospitals are paid on reasonable charges.

Hospitals report charges under revenue code 0636. For EPO, hospitals report charges

under revenue code 0636 with HCPCS code J0885 effective January 1, 2006. Aranesp is

reported with HCPCS code J0881 effective January 1, 2006.

History

(Rev. 1412, Issued: 01-11-08, Effective: 01-01-08, Implementation: 04-07-08)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
f6d098d68de8a554678548d793dbaf2c95310716b9714857a1e18c4f5da01067
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