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CPT 90989

Burton Posted Mon 30th of June, 2014 11:19:39 AM

HOw do you bill for it?

SuperCoder Answered Mon 30th of June, 2014 13:16:20 PM

Thanks for your question. 90989;Dialysis training, patient, including helper where applicable, any mode, completed course can be billed when a patient receives dialysis training from a provider. The patient is trained and in some cases along with a helper to perform dialysis related procedures and self care management. A patient is expected to receive training when it is known that the patient will need dialysis. A dialysis clinic that is certified to provide training and support can bill Medicare for the services. The training program will depend on the modality of the dialysis:

CAPD, Medicare will allow up to 15 training sessions 5–6 sessions a week lasting up to 8 hours.
CCPD, Medicare will allow up to 15 training sessions at 5 exchanges per day 5–6 days a week.
Home hemodialysis, Medicare will allow 2 months of training, 3 times a week.

Please note that 90989 is billed for a complete training program. See the link below for a more detailed account of CMS billing guidelines.
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/bp102c11.pdf

Burton Posted Tue 15th of July, 2014 17:38:57 PM

Can the provider bill medicare for 90989 even if the clinic is not certified to provide training and support. In this example the provider would be bale to bill medicare but not the clinic.

SuperCoder Answered Wed 16th of July, 2014 08:03:07 AM

Is the dialysis training being completed within the facility?

Burton Posted Wed 16th of July, 2014 11:21:17 AM

yes

Burton Posted Wed 16th of July, 2014 11:23:30 AM

The clinic is in the process of getting certified.

SuperCoder Answered Wed 16th of July, 2014 12:38:19 PM

You may want to query your payers to determine if they will allow you to bill retroactively. All of the billing guidelines that I have reviewed for CMS says that the provider can bill but the facility must be certified and will not be able to be reimbursed. See link below section 50.8 for further explanation as well.

http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/clm104c08.pdf

Thank you.

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