Wiki Home Dialysis Training Question

[jenp0913]

What is the required number of completed training sessions for Home Dialysis training in order to bill Medicare for cpt code 90989? I can not seem to locate this information.

 

[pilgrimx4]

Good Luck

There is no hard and fast number on any CMS documents. The code itself does not specify what modality the training is for. There are some that will tell you that it must be 25, but there is NO basis for that number.

The methodology for billing 90993 is reported by the Medicare contractor, Trailblazer, (and others, but I am quoting them specifically) as "Only for purposes of pro-ration, Medicare will consider 25 training treatments as a complete course of training" (reference: http://www.trailblazerhealth.com/Publications/Training Manual/Nephrology.pdf, page 31) this number is used because the Medicare regulations stipulate that the incomplete training cannot exceed $500, and they have assigned the 90993 at $20 per day.

If you do some real digging, you will see that CMS in different publications and manuals identify that there are different "normal" training periods for each modality, Hemo, CCPD, CAPD etc, but still only one code.

I will be writing to CMS for clarification. If I find that I am wrong, I will let you know.