Billing and Coding: Frequency of Hemodialysis

Covers line-item billing for each hemodialysis session for ESRD patients (DOS on/after 4/1/2007), pays up to three treatments per week under ESRD PPS with additional medically necessary treatments payable beyond three, and excludes training sessions and other modalities (e.g., peritoneal dialysis) while not changing other billing rules. Key requirements: follow Noridian LCD L37504 and NCCI coding edits, report each session on a separate line, bill only sessions actually furnished, and maintain the Patient’s Plan of Care and supporting medical records to justify any additional sessions (documentation may be requested and atypical patterns may trigger review).

"Based on the Patient’s Plan of Care (POC) or other available medical documents, the following scheme should be followed when billing sessions."

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