Physicians’ Services Furnished on Day of Dialysis

160.2 - Physicians’ Services Furnished on Day of Dialysis (Rev. 1, 10-01-03) B3-15062.1 Supervision or direction of a dialysis treatment by a physician does not ordinarily meet the requirements for physicians’ services and, therefore, is not paid for as such under the fee schedule. However, physicians are responsible for the medical care and treatment of the dialysis patients. Physicians’ services furnished to those patients that meet the requirements and are medically necessary are covered. The hospital medical record must document the services furnished and the medical reasons for them. Generally, claims from the physician receiving a procedure code payment for additional services furnished to the same patient on the day of dialysis must be reviewed by medical staff prior to payment. Follow §170.B for dialysis and evaluation and management services performed on the same day. Payment in addition to the procedure code payment is made only if the service is not related to the treatment of the patient’s ESRD, and the service was not, and could not have been, furnished during the dialysis treatment. However, an exception to this rule is physicians’ surgical services; e.g., catheter insertion. Physicians’ surgical services are generally billed under the appropriate procedure code for payment. If more than one physician furnishes care to the same dialysis patient, follow the usual coverage rules on concurrent care.