Results 1 to 3 of 3

Thread: End stage Renal codes not covered

  1. #1

    Default End stage Renal codes not covered

    I am receving denials for CPT 90960, 90961, and 90962 from all PA Medicaids stating that it is not a covered code. The patients are in an End-Stage Renal Disease Treatment Facility with a place of service 65. Is there another code I should be billing to receive payment for the provider seeing the patients?

  2. #2


    I'm not too familiar with PA medicaid but I deal with ESRD patients that are under our doctor's care in CA. 90960-90962 are the correct CPT codes when billing CA Medi-Cal (medicaid). It is billed from and through so you would bill a 90960 ex dos: 05/01/13-05/31/13. Check your medicaid billing guidelines on the proper way to bill for ESRD.

    Hope this helped!

  3. #3
    Join Date
    Apr 2007
    Pittsburgh Central Pennsylvania


    Hi. We are receiving the same denials as you are. Have you had any luck finding answers? We have not but we continue to reach out to different entities for help with the same issue you had.

    Beth B.

Similar Threads

  1. End-stage arthritis
    By nabernhardt in forum Diagnosis Coding
    Replies: 4
    Last Post: 05-30-2012, 09:35 PM
  2. End-Stage Heart Failure
    By dwheeler1 in forum Diagnosis Coding
    Replies: 1
    Last Post: 03-06-2012, 10:36 PM
  3. End stage liver disease
    By janyoder in forum Diagnosis Coding
    Replies: 1
    Last Post: 09-06-2011, 03:23 PM
  4. End Stage Liver disease
    By Gemini18 in forum Diagnosis Coding
    Replies: 3
    Last Post: 06-01-2009, 07:08 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts