How is dialysis billed?

How should we bill for this patient? If the patient is a home dialysis patient during the month the management fee for the entire month is billed under the home dialysis codes. The hemodialysis is not billed. Bill CPT code 90966 (adult) for the entire month using the 1st day of the month.

What is MCP dialysis?

A Monthly Capitation Payment (MCP) is a payment made to physicians for most dialysis-related physician services furnished to Medicare End Stage Renal Disease (ESRD) patients on a monthly basis.

What is the CPT code for home hemodialysis?

Report CPT codes 90963-90966 once monthly for home dialysis patients. The physician or practitioner, who provides the complete assessment, establishes the patient’s plan of care and provides ongoing management, should be the one who submits a claim for the monthly service.

How is peritoneal dialysis billed?

Unfortunately, instead of its own section, PD is lumped in with CPT codes for hemofiltration and continuous renal replacement therapies and the section is titled, “Miscellaneous Dialysis Procedures.” In that section, CPT code 90945 is defined as, “Dialysis procedure other than hemodialysis (eg, peritoneal dialysis.

What is monthly capitation payment?

Capitation payments are payments agreed upon in a capitated contract by a health insurance company and a medical provider. They are fixed, pre-arranged monthly payments received by a physician, clinic, or hospital per patient enrolled in a health plan, or per capita.

What does dialysis mean?

Dialysis is a procedure to remove waste products and excess fluid from the blood when the kidneys stop working properly. It often involves diverting blood to a machine to be cleaned.

What is procedure code 99152?

For SVS members who typically treat patients over the age of 5, two CPT codes are important to review: 99152 (Moderate sedation services provided by the same physi- cian or other qualified health care professional perform- ing the diagnostic or therapeutic service that the sedation supports, requiring the presence of …

What is procedure code 90999?

HCPCS code 90999 (unlisted dialysis procedure, inpatient or outpatient) must be reported in field location 44 for bill type 72X. Attach the appropriate G-modifier in field location 44 (HCPCS/RATES), for patients that received seven or more dialysis treatments in a month.

What does Procedure Code 94060 mean?

What is procedure code 94060? CPT code 94060 (bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration) describes a diagnostic test that is utilized to assess patient symptoms that might be related to reversible airway obstruction.

What is medical procedure code does 98966 stand for?

What is medical procedure code does 98966 stand for? CPT 98966, Under Non-Face-to-Face Nonphysician Telephone Services The Current Procedural Terminology ( CPT ) code 98966 as maintained by American Medical Association, is a medical procedural code under the range – Non-Face-to-Face Nonphysician Telephone Services..

What is CPT code 93965 for?

Procedure CODE and Description. 93965 – Noninvasive physiologic studies of extremity veins, complete bilateral study (eg, Doppler waveform analysis with responses to compression and other maneuvers, phleborheography, impedance plethysmography)

What is medical procedure code 92950?

For instance, cardio-pulmonary resuscitation (CPR), Procedure code 92950, is a non-E/M service encompassing such activities as supervising or performing chest compressions, adequate ventilation of the patient (e.g., bag-valve-mask), etc. Procedure does not list a typical time to qualify for providing CPR.