yes you are correct if the visit is esrd related it is included in the mcp. if it not esrd related than you can bill it out seperatly and get paid seperatly you can find this in cpt code book in the exclusion esrd monthly codes "non esrd related e & m services that cannot be performed during the dialysis session"
hopes this helps... example we have esrd patients who aslo have cardiac, dm, htn etc that come in once a month and we bill the e&m.
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