This utilization flag is specific to Erythropoietin (EPO), a naturally occurring hormone, produced by the kidneys, which stimulates the body to produce more red blood cells. EPO also is available as a therapeutic agent used to treat anemia in patients with chronic kidney disease, cancer patients receiving chemotherapy, and HIV-infected individuals receiving AZT therapy. It is also indicated for use in patients scheduled to undergo elective, non-cardiac, non-vascular surgery.
The Utilization Flag software creates 30 data elements that reveal additional information about use of health care services. All of the utilization flags use Uniform Billing (UB-04) revenue codes. Ten of the utilization flags use ICD-9-CM procedure codes. Another ten of the utilization flags use the procedure Clinical Classification Software (CCS). The remaining ten utilization flags do not use procedural information. More information on the Utilization Flags is available under Tools & Software on the HCUP-US Web site.
The utilization flag for EPO is assigned using only revenue codes and is not impacted by the switch from ICD-9-CM to ICD-10-PCS procedure coding in the fourth quarter of 2015.