Coding and Reimbursement Resources
There are two product specific J-Codes for billing MIRCERA®. The appropriate J-Code is based on site of care:
HCPCS Code*1 J0887†, Injection, epoetin beta, 1 microgram, (for ESRD on dialysis)
HCPCS Code*1 J0888†, Injection, epoetin beta, 1 microgram, (for non-ESRD use)
* HCPCS = Healthcare Common Procedure Coding System
† MIRCERA® administered in a dialysis facility to an ESRD patient is covered under the ESRD PPS and included in the base rate payment.
When used to treat patients with ESRD on dialysis, MIRCERA® is included in the ESRD Prospective Payment System (PPS) base rate. The Coding Reference Guide is available to provide additional billing information for MIRCERA®.
It is the provider’s responsibility to ensure correct coding. Codes are provided for informational purposes only, current as of December 6, 2019. For additional information regarding billing and reimbursement for MIRCERA® please contact us at email@example.com or call 1-800-576-8295.
For more information, please see the full Prescribing Information, including Boxed WARNING, and Medication Guide (English, Español) for MIRCERA®.
1Centers for Medicare and Medicaid Services (CMS), January 2015 Update of the Hospital Outpatient Prospective Payment System (OPPS): MM9014, https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM9014.pdf. Accessed August 15, 2019.