End-Stage Renal Disease
This page is a central location for end-stage renal disease (ESRD) information, including CMS resources.
Spotlight
Policy Information
Not all services have a policy associated with them. We will consider Reasonable and Necessary Guidelines in the absence of a LCD, billing and coding article, NCD, or CMS manual instruction that limits coverage.
LCDs
Learn more about the LCD development process through the following:
Search for ESRD-related LCDs using these available tools:
- LCD Interactive Index Tool
- View active / proposed LCDs on CMS Medicare Coverage Database (MCD)
NCD
Search for ESRD related NCDs using these available tools:
Medical Documentation
For a claim to be valid, documentation must demonstrate compliance with all applicable coverage, coding and billing requirements and substantiate the level of care billed. The following resources are specific to ESRD, but may not address all required medical documentation requirements:
Claim Submission and Reimbursement
- Acute Kidney Injury (AKI)
- ESRD Billing Requirements
- Ending AX Modifier Requirements for AKI and ESRD
- ESRD Billing Reminders and Quarterly Updates
- ESRD: Payment for Phosphate Binders Effective January 1
- Resolution Tips for Overlapping Claims
Additional Information
- View our FastTrack to Medicare Coverage Policies tool to locate guidelines
CMS
- End Stage Renal Disease Facility Providers
- ESRD PPS Patient-Level Adjustments
- ESRD Payment Regulations and Notices
- Erythropoietin Stimulating Agents Policies
- ESRD Network Organizations
- ESRD PPS Consolidated Billing
- End Stage Renal Disease (ESRD) Prospective Payment System (PPS)
- ESRD Quality Incentive Program
- End-Stage Renal Disease Information Center
- CMS IOM Pub. 100-02 Medicare Benefit Policy Manual, Chapter 11
- CMS IOM Pub. 100-04 Medicare Claims Processing Manual, Chapter 8
- CMS IOM Pub. 100-04 Medicare Claims Processing Manual, Chapter 16
- CMS IOM Pub. 100-05 Medicare Secondary Payer (MSP) Manual, Chapter 2
Education
View our wide selection of free, live and on-demand training options:
- View our upcoming Educational Events Calendar
- View On-Demand Learning
Stay Informed
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