Bundled Payment Options: Data Tables

ESRD Bundled Payment OptionsIndex of Data TablesTablePageTable Key1 Bundle Defintions3 Drugs3 Laboratory Tests4 Table 0-1 Summary of Options: All Patients13 Table 0-2 Summary of Options: PD Patients15 Table 0-3 Summary of Options: HD Patients17 Table 0-4 Summary of Options: HD Patients / Full Month 19 Table 0-5 HD Equivalent Sessions21 Table 0-6 Composite Rate Services24 Table 1A-1 Bundle 1A Total MAC30 Table 1A-2 EPO and Aranesp36 Table 1A-3 Iron42 Table 1A-4 Vitamin D48 Table 1A-5 Anemia Lab Tests54 Table 1A-6 Vitamin D Lab Tests60 Table 1B-1 Bundle 1B Total MAC66 Table 1B-2 Levocarnitine72 Table 1B-3 Altaplase78 Table 1B-4 Vancomycin84 Table 1B-5 Infection Lab Tests90 Table 1B-6 Carnitine Lab Tests96 Table 1C-1 Bundle 1C Total MAC102 Table 1C-2 Other injectable drugs108 Table 1C-3 Other Lab Tests114 Table 1D-1 Bundle 1D Total MAC120 Table 1D-2 Other facility services126 Table 2A-1 Bundle 2A Total MAC132 Table 2A-2 Physician MCP138 Note 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

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