Erythropoiesis Stimulating Agents

This LCD covers erythropoiesis-stimulating agents (ESAs) for specific indications: chemotherapy-induced anemia in non-myeloid malignancies (when Hb <10 g/dL or HCT <30%), symptomatic anemia of ESRD and advanced CKD (stages IIIb–V), AZT-induced anemia in HIV/AIDS, selected low‑risk MDS, and perioperative use for major hip/knee surgery under defined criteria. Before initiating ESAs, reversible causes of anemia must be evaluated and documented, dosing must follow FDA‑approved labeling with titration to target Hb 10–12 g/dL (HCT 30–36%), and Hb should not be raised above 12 g/dL except in rare documented circumstances; several numerical fields in the source text are truncated and should be reviewed clinically for precise thresholds.

"ESA therapy is covered for treatment of significant anemia in patients with non-myeloid malignancies when the anemia is specifically due to concomitantly administered myelosuppressive chemotherapy."