ED HCPCS Level II modifier: Hematocrit level has exceeded 39% (or hemoglobin level has exceeded 13.0 g/dl) for 3 or more consecutive billing cycles immediately prior to and including the…
ED is a HCPCS Level II modifier: “Hematocrit level has exceeded 39% (or hemoglobin level has exceeded 13.0 g/dl) for 3 or more consecutive billing cycles immediately prior to and including the current cycle.” It adds this detail to the code it is reported with.
Official description
EDHematocrit level has exceeded 39% (or hemoglobin level has exceeded 13.0 g/dl) for 3 or more consecutive billing cycles immediately prior to and including the current cycle
Short description: Hct>39% or hgb>13g>=3 cycle
HCPCS · United States
Notes for ED
As CMS prints them, with any note ED takes from the headings above it.
Note
- CMS processing note 0145: MEDICARE CLAIMS PROCESSING MANUAL PUB 100-4, CHAPTER 8, SECTION 60.4.
Medicare details
The indicators CMS publishes with ED in its October 2026 file. They describe Medicare’s handling, not another payer’s.
- Medicare coverage
- Special coverage instructions apply
- Added
- Jan 1, 2008
Where ED sits
- 1GroupHCPCS modifiers
- 2Modifier EDHematocrit level has exceeded 39% (or hemoglobin level has exceeded 13.0 g/dl) for 3 or more consecutive billing cycles immediately prior to and including the current cycle
Source and release
- Data release
- HCPCS Level II · October 2026
- Effective date
- Oct 1, 2026
- Publisher
- CMS
This page is built from the HCPCS Level II catalog that Vero Codes reads when it suggests codes: Centers for Medicare & Medicaid Services’s October 2026 release, imported from the publisher’s file and checked against it. The description, notes and structured data come from the same record.
Frequently asked questions
What does HCPCS code ED mean?
ED is the HCPCS code for “Hematocrit level has exceeded 39% (or hemoglobin level has exceeded 13.0 g/dl) for 3 or more consecutive billing cycles immediately prior to and including the current cycle” in CMS’s HCPCS Level II October 2026 release.
Where is ED in the HCPCS Level II list?
ED is listed under Modifiers.
Does Medicare cover ED?
CMS lists ED’s Medicare coverage as “Special coverage instructions apply”. Coverage and payment still depend on the patient, the setting, the documentation and the payer.
Which HCPCS Level II release does this page use?
It uses CMS’s October 2026 release, in effect from Oct 1, 2026 to Dec 31, 2026. It is a reference: confirm the code against the current list and the payer’s rules before you submit it.
Codes beside ED
All modifiersE2Lower left, eyelidE3Upper right, eyelidE4Lower right, eyelidEAErythropoietic stimulating agent (esa) administered to treat anemia due to anti-cancer chemotherapyEBErythropoietic stimulating agent (esa) administered to treat anemia due to anti-cancer radiotherapyECErythropoietic stimulating agent (esa) administered to treat anemia not due to anti-cancer radiotherapy or anti-cancer chemotherapyEEHematocrit level has not exceeded 39% (or hemoglobin level has not exceeded 13.0 g/dl) for 3 or more consecutive billing cycles immediately prior to and including the current cycleEJSubsequent claims for a defined course of therapy, e.g., epo, sodium hyaluronate, infliximabEMEmergency reserve supply (for esrd benefit only)EPService provided as part of medicaid early periodic screening diagnosis and treatment (epsdt) programERItems and services furnished by a provider-based, off-campus emergency departmentETEmergency services