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90970 used when comp visit is absent

Burton Posted Mon 04th of August, 2014 17:24:41 PM

Our doctor had 4 face-to-face dialysis visits with a patient but failed to perform a complete round . The patient dialyzed three times per week throughout the month. What is the quantity of 90970 to be billed (or how many dates)?

SuperCoder Answered Tue 05th of August, 2014 06:48:08 AM

Thank you for your question.

The code 90970 is coded per day. Please see criteria below:

Codes 90967-90970 are reported to distinguish age-specific services for end-stage renal disease (ESRD) services for less than a full month of service, per day, for services provided under the following circumstances: home dialysis patients less than a full month, transient patients, partial month where there was one or more face-to-face visits without the complete assessment, the patient was hospitalized before a complete assessment was furnished, dialysis was stopped due to recovery or death, or the patient received a kidney transplant. For reporting purposes, each month is considered 30 days.

The provider reports this code per day in situations such as a home dialysis patient who receives a partial month of dialysis; a transient patient or patient traveling away from home who receives services for less than a month; a patient who has one or more face–to–face visits without a complete assessment and the patient is either hospitalized before the assessment is done, dialysis stops due to death, or the patient has a transplant; or when the patient permanently changes his provider during the month.

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