Wiki ESRD Code Requirements

[abrunhoelzl]

Are there any requirements for using CPT codes 90951-90962?

Can 90951-90962 be used when the below listed codes are used throughout the same month service dates?
Hemodialysis procedure with evaluation
Electrocardiogram
Echocardiography
Office Visits
Hospital Care

Does it need to be performed at a specific location like a Kidney Center? When billing, do you need to enter the from and through date as the 1st and last day of the month?
Do some insurance companies not accept these codes?
Is ICD 585.6 sufficient to use with these codes or is another code needed?

Thank you

Thank you.

 

[Julianna22]

That code set is only payable in a dialysis center location and any other care provided by the supervising physician is rolled into your monthly visits. I'm not sure why a nephrologist would be providing an echo or EKG, but if another physician provided the service it should be fine. I would recommend reading Medicare's claims manual for ESRD as they provide examples of different scenarios and very clearly tell you how you should be billing.

 

[Julianna22]

Oh and just to clarify on the echo and EKG, by another physician, I mean a cardiologist at another practice. Not one of the other providers in the same practice.

 

[abrunhoelzl]

Thank you.