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Outpatient ESRD

Kelly Posted Wed 10th of April, 2019 14:59:41 PM
Is there a reportable CPT code for outpatient dialysis for an ESRD patient? This is performed in a Certified Dialysis Children's Hospital.
SuperCoder Answered Thu 11th of April, 2019 04:36:34 AM

HCPCS code G0257 (Unscheduled or emergency dialysis treatment for an ESRD patient in a hospital outpatient department that is not certified as an ESRD facility) covers urgent or unscheduled dialysis in patients with end stage renal disease, or ESRD, in a hospital outpatient department. This code can be used when facility is not certified as an ESRD facility. So, it is not be appropriate to use it as your center is Certified Dialysis Hospital.

Over the last few years, the physicians have made significant advances in minimally invasive medical procedures. Lots of treatments, including access creation and management, are now available via minimally invasive techniques in an outpatient setting, like dialysis for ESRD.

There is no specific procedure code to describe the situation, however, you can bill the dialysis procedure code under place of service (POS) of outpatient with the diagnosis of ESRD. Although, many payers do not accept the claim this way. It is suggested to check the policy and get in touch with your payer for further clarification.

Hope this helps!

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