Just a reminder, there are specific codes to submit for home dialysis services. The monthly codes are used when a patient receives uninterrupted dialysis in their home (full month).
|
Monthly
|
Patient Age
|
HCPCS Code
(Dates of Service Prior to 1/1/09)
|
CPT Code
(Dates of Service After 1/1/09)
|
|
Under 2
|
G0320
|
90963
|
|
Ages 2 – 11
|
G0321
|
90964
|
|
Ages 12 – 19
|
G0322
|
90965
|
|
Ages 20 and over
|
G0323
|
90966
|
There are also daily home dialysis codes for less than a full month. The daily codes are used when there is a break in the month (e.g., the patient is hospitalized).
|
Daily
|
Patient Age
|
HCPCS Code
(Dates of Service Prior to 1/1/09)
|
CPT Code
(Dates of Service After 1/1/09)
|
|
Under 2
|
G0324
|
90967
|
|
Ages 2 – 11
|
G0325
|
90968
|
|
Ages 12 – 19
|
G0326
|
90969
|
|
Ages 20 and over
|
G0327
|
90970
|
When submitting claims with the daily codes for consecutive days, identify the span of dates as the date of service and utilize the DAYS/UNITS field.
For example, an adult patient receives home dialysis the first 20 days of the month and is hospitalized the last 10 days of the month. (Remember that a full month is 30 days regardless of the number of days there are in a calendar month.) The claim for home dialysis should be submitted with HCPCS code G0327 for dates of service 2/1/08 through 2/20/08 with 20 in the DAYS/UNITS field.
Resources
- Outpatient ESRD Hospital, Independent Facility, and Physician/Supplier Claims, Pub. 100-04, Chapter 8 (PDF, 625 KB)
- Laboratory Services, Pub. 100-04, Chapter 16 (PDF, 458 KB)
- End Stage Renal Disease Information, Pub. 100-02, Chapter 11 (PDF, 348 KB)
- Physicians' Guide to Medicare Coverage of Kidney Dialysis and Kidney Transplant Services (PDF, 1.65 MB)