Pharmacy Question for the Week of February 4, 2019

Question:

When is Procrit covered for a patient?

Answer:

A Medicare Part B contractor may determine that Procrit is covered for individuals who:

• Are undergoing hip or knee surgery
• Have an anemia with a hemoglobin between 10 and 13 mg/dL
• Are not a candidate for autologous blood transfusion
• Expected to lose more than 2 units of blood and
• Have had a workup so that their anemia appears to be that of chronic disease.

In other cases, Procrit is considered a preventive service and therefore not covered.