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®.Coding Reference Guide
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.