Wiki ESRD Management - no Complete Assessment

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amberlarsen820

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If a ESRD patient is seen less than 4 times a month, and no complete assessment was completed, can you still bill the less than 4 visits a month?

MCR guidelines are very very vague!

Thanks for any help in advance!
 
A complete assessment is required when using the monthly dialysis codes regardless of the number of visits. There are a few exceptions, but even in those cases you would use the daily code not the monthly code. You can find a lot of good information in the Medicare Claims Processing Manual Chapter 8 pages 110-135. Another good place to get information is on the Renal Physicians Association's (RPA) listserv (rpabilling@googlegroups.com). Hope this helps.

Laura L. Porter, CPC
 
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