Bundled Payment Options: Data Tables

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ESRD Bundled Payment OptionsIndex of Data TablesTablePageTable Key1Bundle Defintions3Drugs3Laboratory Tests4Table 0-1 Summary of Options: All Patients13Table 0-2 Summary of Options: PD Patients15Table 0-3 Summary of Options: HD Patients17Table 0-4 Summary of Options: HD Patients / Full Month 19Table 0-5 HD Equivalent Sessions21Table 0-6 Composite Rate Services24Table 1A-1 Bundle 1A Total MAC30Table 1A-2 EPO and Aranesp36Table 1A-3 Iron42Table 1A-4 Vitamin D48Table 1A-5 Anemia Lab Tests54Table 1A-6 Vitamin D Lab Tests60Table 1B-1 Bundle 1B Total MAC66Table 1B-2 Levocarnitine72Table 1B-3 Altaplase78Table 1B-4 Vancomycin84Table 1B-5 Infection Lab Tests90Table 1B-6 Carnitine Lab Tests96Table 1C-1 Bundle 1C Total MAC102Table 1C-2 Other injectable drugs108Table 1C-3 Other Lab Tests114Table 1D-1 Bundle 1D Total MAC120Table 1D-2 Other facility services126Table 2A-1 Bundle 2A Total MAC132Table 2A-2 Physician MCP138Note to user:Each of the Tables beginning with Table 0-6 (for compositerate services) consists of six pages.

Bundled Drugs and Laboratory Tests Preliminary - March 11, 2005 Included in bundle: HCPCS Name 1A 1B 1C Use Notes 87077 CULTURE AEROBIC IDENTIFY X X Infection 1,2,3,4 87081 CULTURE SCREEN ONLY X X Infection 1,2,3,4 87086 URINE CULTURE/COLONY COUNT X X Infection 1,2,3,4 87088 URINE BACTERIA CULTURE X X Infection 1,2,3,4

  Notes, Drug