36104

FISS Narrative
Condition codes 71, 72, 73, 74, 75 and 76 cannot be present on the same ESRD claim at the same time.

Explanation and Suggestions:
Condition codes 71 through 76 are applicable renal dialysis facility codes that indicate the type of dialysis care and/or location for the patient.

  • 71 – Full care in unit
  • 72 – Self-care in unit
  • 73 – Self-care training
  • 74 – Home
  • 75 – Home (100 percent reimbursement)
  • 76 – Backup in-facility dialysis

There can only be one ESRD condition code on the bill. Please verify the condition codes listed on the bill and correct and resubmit, if necessary.

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