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NCD 110.21 Erythropoiesis Stimulating Agents (ESAs) in Cancer and Related Neoplastic Conditions Effective July 1, 2018, CMS added Q5106 Injection, epoetin alfa, biosimilar, (Retacrit) (for non-ESRD use), 1,000 units to the list of codes: Part A MACs and FISS shall deny Q5106 billed with modifier EC ESA, anemia, non-chemo/radio when any one of the specified noncovered diagnosis codes is present on the claim

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The challenge with making sense of these associations is that Ive not seen a single study in a pregnant population that is not also supplemented with high doses of folic acid