The Erythropoietin Drug Policy (EPO) Attachment, is used to report information required by some carriers for the administration of Erythropoietin to adhere to the Erythropoietin Drug Policy (EPO). The entry of any of the following Erythropoietin procedure codes will trigger this attachment: J0881, J0882, J0885, J0886 and Q4081.
When an insurance claim is printed, the EPO information will print above
the procedure code line item. The EPO does not require a qualifier, so
there will be two blank spaces in front of the EPO information.
Data Field Information
| Prompt | Response | Req | Len |
|---|---|---|---|
| Measurement Ref ID | Select the Measurement Ref ID you want from the list. | 
|
1 |
| Measurement Qualifier | Select the Measurement Ref ID you want from the list. |
|
1 |
| Measurement Value | Enter the Measurement Value. | 20 |
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