I am fairly new with Hem/Onc coding and need some help with ESA’s. Our providers give Aranesp and I am trying to understand the Medicare NCD. I get that anemia in cancer or cancer treatment patients die to the deficiencies, and CML/AML patients. Anemia in neoplastic disease would not be covered, correct? If the patient has anemia due to chemotherapy, that should be covered, correct? Some of our patients have MDS which was covered but is it now? What is even more confusing is the Medicare denied the Aranesp for AML but then came back and paid it.

I appreciate any help with this!!