Billing Monthly ESRD Codes

Providers who submit claims for monthly end stage renal disease (ESRD) services (e.g., CPT® codes 90951 through 90966) should be aware of how to complete the Days/Units and Dates of Service (DOS) fields, reminds jurisdiction 1 Part B Medicare administrative contractor Palmetto GBA.

Days/Units

  • Enter ‘1’ for the month
    • ANSI 5010 electronic claims: Loop 2400, Segment SV1 and Element 04 (03=UN)
    • CMS 1500 claims: Item 24g

Dates

  • Enter a span of dates within the month billed
    • ANSI 5010 electronic claims: Enter the last DOS in Loop 2400, Segment DTP/472, Element 03
    • CMS 1500 claims: Item 24a

Example: For services provided during August 2011 (Aug. 1 through Aug. 29), enter “08/29/11” as the date and “1” for the days/units.

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One Response to “Billing Monthly ESRD Codes”

  1. Vinod says:

    Great update…..

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