Wiki POS requirements for CKD education G0420

[swinn]

Are any Nephrology groups billing CKD education G0420? We billed it in the past at place of service office(11). The doctor's want to know if they can use place of service ESRD clinic(65) for these charges. I see Medicare does not allow the ESRD facility itself to bill these charges, but I was unclear if we could see patients that were CKD level 4(N18.4) at the clinic location?

 

[Codingabc123]

Medicare has paid using POS 65, 90989 and ICD-10 should be N18.6 as the assumption is the patient is being trained for dialysis due to reaching that level of the disease process. See https://www.palmettogba.com/palmetto/jmb.nsf/DID/BAAN777078 and CMS Claim Processing Manual 100-04, Chapter 8, Section 150.