vshubert
Contributor
I have been reviewing the Medicare Claims Processing Manual and looking at other resources to get clarification regarding submitting a claim for patient that received dialysis. I know when the patient is inpatient and they receive dialysis the CPT code used is 90935. But if the patient is listed as outpatient or observation from what I understand the CPT 90935 can not be used for outpatient/observation status patients. I know previously 90935 had been submitted to other insurance companies in the situation of an outpatient/observation status patient and at first the insurance company paid the claim but then later we received an request for refund of payment back to insurance company. I just wanted to see if I could get clarification regarding outpatient dialysis charges at a hospital setting. Thank you so much in advance.