Federal (United States) · Agency guidance
Chapter 8
87 sections
87 sections
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 10General Description of the End Stage Renal Disease Prospective
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 10.1Billing for Additional Treatments
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 10.2Uncompleted Treatments
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 10.3No-Shows
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 10.4Deductible and Coinsurance
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 10.5Hospital Services
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 10.6Amount of Payment
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 10.7ESRD Services Not Provided Within the United States
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 10.8Transportation Services
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 10.9Dialysis Provider Number Series
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 20End Stage Renal Disease Prospective Payment System (ESRD PPS)
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 20.1Calculation of the Basic Case-Mix Adjusted Composite Rate and
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 20.1.1Calculation for Double Amputee Dialysis Patients
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 20.2Pediatric Payment Model for ESRD PPS
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 20.3End Stage Renal Disease Quality Incentive Program (ESRD QIP)
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 30Publication of the Prospective Payment System (PPS) Base Rate
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 40Acute Kidney Injury (AKI) Claims
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 50Dialysis Bill Processing Procedures
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 50.1Laboratory Services Included in the End Stage Renal Disease
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 50.1.1Laboratory Services Performed During Emergency Room
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 50.2Drugs and Biologicals Included in the End Stage Renal Disease
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 50.3Required Information for In-Facility Claims Paid Under the End
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 50.4Line Item Detail Billing and Automated Claim Adjustments
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 50.5Intermittent Peritoneal Dialysis (IPD) in the Facility
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 50.6In-Facility Back-Up Dialysis
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 50.6.1Payment for In-Facility Maintenance Dialysis Sessions
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 50.6.2Payment for Hemodialysis Sessions
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 50.7Ultrafiltration
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 50.8Training and Retraining
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 50.9Coding for Adequacy of Dialysis, Vascular Access and Infection
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 60Separately Billable ESRD Items and Services
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 60.1Lab Services
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 60.2Drugs Furnished in Dialysis Facilities
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 60.2.1Billing Procedures for Drugs for Facilities
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 60.2.1.1Separately Billable ESRD Drugs
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 60.2.1.2Facilities Billing for ESRD Drugs and Biologicals Equivalent
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 60.2.2Drug Payment Amounts for Facilities
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 60.2.3Facility Billing Requirements to the A/B MAC (A)
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 60.2.4Physician Billing Requirements to the A/B MAC (B)
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 60.3Blood and Blood Products Furnished in Hospital Based and
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 60.4Erythropoietin Stimulating Agents (ESAs)
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 60.4.1ESA Claims Monitoring Policy
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 60.4.2Facility Billing Requirements for ESAs
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 60.4.4Payment Amount for Epoetin Alfa (EPO)
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 60.4.4.1Payment for Epoetin Alfa (EPO) in Other Settings
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 60.4.4.2Epoetin Alfa (EPO) Provided in the Hospital Outpatient
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 60.4.5.1Self Administered ESA Supply
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 60.4.6.1Reserved for Future Use
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 60.4.6.2Reserved for Future Use
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 60.4.6.3Payment Amount for Darbepoetin Alfa (Aranesp)
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 60.4.6.4Payment for Darbepoetin Alfa (Aranesp) in Other Settings
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 60.4.6.5Payment for Darbepoetin Alfa (Aranesp) in the Hospital
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 60.5Intradialytic Parenteral/Enteral Nutrition (IDPN)
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 60.6Vaccines Furnished to ESRD Patients
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 60.7Reserved For Future Use
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 70Payment for Home Dialysis
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 70.1Overpayments
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 80Home Dialysis Method I Billing to the A/B MAC (A)
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 80.1Items and Services Included in the ESRD PPS payment for Home
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 80.3Calculating Payment for Intermittent Peritoneal Dialysis (IPD)
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 80.4Calculating Payment for Continuous Ambulatory Peritoneal
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 90Reserved for Future Use
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 100Dialysis Sessions Furnished to Patients Who are Traveling
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 100.1Physician’s Services Furnished to a Dialysis Patient Away From
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 110Reduction in Medicare Program Payment to Fund ESRD
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 120Renal Transplantation and Related Services
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 120.1Payment for Immunosuppressive Drugs Furnished to
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 130Physicians and Supplier (Nonfacility) Billing for ESRD Services -
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 130.1Initial Method for Physician’s Services to Maintenance Dialysis
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 140Monthly Capitation Payment Method for Physicians’ Services
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 140.1Payment for ESRD-Related Services Under the Monthly
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 140.1.1Payment for Managing Patients on Home Dialysis
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 140.1.2Patients Who Switch Modalities (Center to Home and Vice
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 140.2Payment for ESRD-related services (Per Diem)
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 140.2.1Guidelines for Physician or Practitioner Billing -- (Per Diem)
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 140.3Data Elements Required on Claim for Monthly Capitation
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 140.4Controlling Claims Paid Under the Monthly Capitation Payment
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 150Physician’s Self-Dialysis Training Services
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 160Payment for Physician’s Services Furnished to Dialysis Inpatients
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 160.1Determining Whether Physician Services Furnished on Day of
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 160.2Physicians’ Services Furnished on Day of Dialysis
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 160.3Physicians’ Services Furnished on Non-Dialysis Days
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 160.4Requirements for Payment
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 170Billing Physician Dialysis Services (codes 90935 - 90999) and
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 180Noninvasive Studies for ESRD Patients - Facility and Physician
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 190Appeal Rights for Denied Claims
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 200Utilization of REMIS for A/B MAC (B) Claims Adjudication