Acute kidney injury
Since January 1, 2017, Medicare has covered and made payments to both hospital-based and freestanding end-stage renal disease (ESRD) facilities for renal dialysis services furnished to beneficiaries with acute kidney injury (AKI).
There are no billing limits for treatments during a monthly billing cycle; however, there will only be payment for one treatment per day.
ESRD facilities must provide all items and services necessary to treat their patients with AKI.
Items and services NOT considered renal dialysis services, but related to AKI, are paid separately.
Do not report modifier AY or procedure code 90999 (dialysis procedure code) on claims with AKI services.
The ESRD network fee reduction does not apply to AKI claims.
Billing requirements
| Type of bill | 72X |
|---|---|
| Revenue code | 082X, 083X, 084X or 085X |
| CPT code | G0491 (dialysis procedure at a Medicare certified ESRD facility for AKI without ESRD) |
| Diagnosis code (only one) |
N17.0 - Acute kidney failure with tubular necrosis N17.1 - Acute kidney failure acute cortical necrosis N17.2 - Acute kidney failure with medullary necrosis N17.8 - Other acute kidney failure N17.9 - Acute kidney failure, unspecified T79.5XXA - Traumatic anuria, initial encounter T79.5XXD - Traumatic anuria, subsequent encounter T79.5XXS - Traumatic anuria, sequela N99.0 - Post-procedural (acute) (chronic) renal failure |
References