Diagnosis billing with J0888
January 9th, 2018 - Find-A-CodeThe following information is from LCD L36276.
The diagnosis codes listed below require the use of the EC modifier (ESA administered to treat anemia not due to anti-cancer radiotherapy or anti-cancer chemotherapy) when submitting claims for J0888. In addition, these diagnosis codes are marked with an * indicating they require a dual diagnosis. The dual diagnosis rule is outlined below.
- D63.1* - Anemia in chronic kidney disease
- I12.0* - Hypertensive chronic kidney disease with stage 5 chronic kidney disease, or end stage renal disease
- Hypertensive heart and chronic kidney disease with stage 5 chronic kidney disease, or end stage renal disease
- Chronic kidney disease (CKD)
Dual diagnosis rule:
I12.0, I13.11, I13.2, N18.1, N18.2, N18.3, N18.4, N18.5, OR N18.9, AND D63.1 MUST BE BILLED TOGETHER.
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