Billing for Physicians’ Services for Individuals with AKI

100.7 Billing for Physicians’ Services for Individuals with AKI (Rev. 240, Issued: 01-19-18, Effective: 01-01-17, Implementation: 02- 20-18) Physicians are able to bill separately for services provided to individuals with AKI. CMS expects providers to follow correct coding guidelines and use the appropriate HCPCS or CPT codes for the items and services provided to the patient. The following CPT codes are available for ESRD facilities and physician’s offices to use when billing for physicians’ services provided in either an ESRD facility (place of service 65) or a physician’s office (place of service 11): • 90935 - Hemodialysis procedure with single evaluation by a physician or other qualified health care professional; • 90937 - Hemodialysis procedure requiring repeated evaluation(s) with or without substantial revision of dialysis prescription; • 90945 - Dialysis procedure other than hemodialysis (eg, peritoneal dialysis, hemofiltration, or other continuous replacement therapies), with single evaluation by a physician or other qualified health care professional; • 90947 - Dialysis procedure other than hemodialysis (eg, peritoneal dialysis, hemofiltration, or other continuous renal replacement therapies) requiring repeated evaluations by a physician or other qualified health care professional, with or without substantial revision of dialysis prescription. Please note: this is not an exhaustive list – as indicated above, CMS expects facilities and physician’s offices to bill the appropriate codes.