Wiki HD (90935/90937) in the observation unit

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amsmith

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Can anyone tell me how they handle billing for HD while the ESRD patient is still in observation? According to the CPT the 90935/90937 are for non-ESRD patients on an outpatient basis and for ESRD and non-ESRD while inpatient. We have a few "out of towners" that are brought to the ER and put in observation for other things, but while they are here they need HD. Does anyone else have this problem? Any suggestions?
 
meme

This observation status is still technically outpatient, so for transient ESRD patients, we bill the daily rate code 90970 and for non-ESRD patients, we code 90935 or 90937.
 
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