End-stage renal disease (ESRD)
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Spotlight
End-stage renal disease (ESRD) billing requirements
LCD / NCD – policy information
LCD
Search for ESRD-related LCDs using these available tools:
- LCD interactive index tool
- View First Coast’s active / proposed LCDs / articles on CMS’ Medicare coverage database (MCD)
NCD
Education
Utilize educational information from First Coast and CMS on end-stage renal disease (ESRD) services.
- View First Coast upcoming events
- Search for CMS upcoming events
- CMS open door forums
CMS Internet-only manual (IOM)
The CMS’ IOMs contain day-to-day operating instructions, policies, and procedures based on statutes, regulations, guidelines, models, and directives. The following CMS IOMs contains information specific to end-stage renal disease (ESRD) providers:
- Publication 100-04, Medicare Claims Processing Manual, Chapter 8
- Publication 100-02, Medicare Benefit Policy Manual, Chapter 11
- Publication 100-03, Medicare National Coverage Determination Manual, Chapter 1, Part 2, Section 110.10
- Publication 100-03, Medicare National Coverage Determination Manual, Chapter 1, Part 2, Section 110.15
Resources
Listed below are additional resources identified specifically for end-stage renal disease (ESRD) providers:
- CMS Certification & Compliance
- Conditions for Coverage & Conditions of Participation
- End-stage renal disease – General information
- ESRD coordination period calculator
Use this calculator to determine a beneficiary's ESRD coordination period. - ESRD Prospective Payment System (PPS)
- ESRD PC Pricer
- MLN Matters® articles: MM9598
- Provider Compliance Tips for Clinic End-Stage Renal Disease (ESRD) Services (Part A non-DRG) external pdf file
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