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2009 Deleted HCPCS codes for ESRD - greatly appreciated

  1. #1
    Question 2009 Deleted HCPCS codes for ESRD - greatly appreciated
    Medical Coding Books
    Does anyone know of any replacement codes for the End Stage Renal Disease G codes that are being deleted as of 1/1/09? I do not have my new book yet and have not found any in my research. Any help would be greatly appreciated!

  2. #2
    HCPCS G0308-G0327 and CPT 90918-90925 were deleted for 2009 to be replaced by CPT 90951-90970. These new CPT codes would be used for the deleted HCPCS codes too.
    Pam Tienter, CPC, COC, CPC-P, CCS-P, CPMA, CPC-I, AAPC Fellow
    National Advisory Board Member 2018-2021, Region 6 Great Lakes
    Minneapolis AAPC Chapter, Education Officer 2018
    AHIMA ICD-10-CM/PCS Trainer
    AAPC National ICD-10 Trainer

  3. Default new dialysis codes.
    4 or more face to face visits
    90951- younger then 2yrs
    90954 - 2-11 yrs
    90957 -12-19 yrs
    90960 - 20yr & older

    2-3 face to face visit
    90952- youger then 2 yrs
    90955 - 2-11
    90958 - 12-19
    90961- 20 yr s & older

    1face to face visit
    90953 - younger then 2yrs
    90956 2-11
    90959 - 12-19
    90962 - 20 yrs & older

    for dialysis less then full month
    90967 - younger 2 yrs
    90968 2-11
    90969 12-19
    90970 20 yrs & older

  4. Default Coding Institute request
    My name is Chris, and I am an editor at The Coding Institute. I am writing because I am working on a story about the ESRD code changes 90951-90970 (and other codes); I had a couple of questions I was hoping to get some expert input on.

    Would any of you 3 be willing to answer a couple of questions for me on the changes? (See below). Any help you could offer would be appreciated.
    Chris Boucher, CPC

    1. Is this statement accurate? According to HCPCS Level-II 2009 manual, Medicare's ESRD codes G0308-G0327 have been deleted. Instead, use the new CPT Category I codes 90951-99070.

    2. For inpatient ESRD and non-ESRD procedures or for outpatient non-ESRD dialysis services, what should coders report? (Research indicates CPT “Hemodialysis” codes 90935-90940)

  5. Default limits for dialysis codes
    Hi - just checking on limits and uses for the new dialysis codes (non-home location)

    90960 - this is a monthly code, so if billed for a 1 month span, it should be 1 unit (if more than 4 face to face visits were provided). Please confirm.

    90970 - since this is a partial code, (less than a full month), it should be billed daily for as many days as it was provided. Please confirm.

    During 1 month span, could these 2 codes be billed together? If the month was partial? 90970 for the first 10 days, then a break because the patient was admitted to the hospital for 10 days. Then for the remaining 11 days, if more than 4 face to face visits, can 90960 be billed also on the same claim?

    I'm thinking 90970 should be billed on all days in the above example (21), with the exception of the days that the patient was in the hospital.

    If anyone can provide more clarification, that would be great!

    Thank you for any assistance you can provide.

  6. #6
    I was taking the pre-test today that came with the CPC Exam Study Guide and came across a question which included the following codes: 90960, 90961, 90962 and 90970. I have the CPT 2008 book, which does not include those codes. Will I still be okay as far as the exam goes, since I do not have the 2009 edition?

  7. #7
    Milwaukee WI
    Default Use the CURRENT CPT book
    scheyenne asks:
    I have the CPT 2008 book, which does not include those codes. Will I still be okay as far as the exam goes, since I do not have the 2009 edition?

    You are allowed to use the current or immediate prior year's CPT books.

    BUT the exam is written based on the current year's CPT book. Codes change. If you do not have a current CPT book you will be at a disadvantage.

    Just my opinion.

    F Tessa Bartels, CPC, CEMC

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