Wiki nephrology hemo pd billing

[Robinznest]

I am receiving mixed information regarding billing Nephrology Hemo and Pd patients if someone can clear this up it would be great. Which way do most of your bill?
Billing for MCP if done in office pos 11 not Facility pos 65.
RPA is telling me must put pos 11 not an option, Medicare is telling me either way is correct,
Commercial Insurance are giving me both answers.
Thanks, Robin

 

[carynrobison]

We bill only place of service 65 for Hemo and PD. Our providers go to the patient at the facility regardless of Hemo or PD. We have PD clinic once per week, but it is at the dialysis facility and not at our office.

Caryn

 

[mmsnyrobi]

Renal Physician Association (RPA) advise physicians how to code compliantly. Payer policies reflect the carrier determinations for reimbursement of services. Medicare is a payer as well as commercial insurance companies. With that being said I would recommend adherence to the recommendation from the physician association since they also aid the AMA in determining how to utilize the codes for CPT.