Response to Comments: Frequency of Hemodialysis

Medicare payment for hemodialysis beyond the standard thrice-weekly schedule is allowable for ESRD patients when medical documentation supports one of the MAC-defined clinical conditions, or when unlisted conditions are indicated with the KX modifier and documentation. MACs cannot alter CMS base payment policies; denials for unlisted diagnoses may be appealed via redetermination and can prompt addition of diagnosis codes to the LCD after review.

"Hemodialysis beyond the standard thrice-weekly schedule is covered for End Stage Renal Disease (ESRD) patients when medical documentation supports one of the clinical conditions listed by the Medic..."

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