{"id":3861,"date":"2024-03-11T05:14:08","date_gmt":"2024-03-11T09:14:08","guid":{"rendered":"https:\/\/medrbs.com\/?p=3861"},"modified":"2024-03-11T05:14:09","modified_gmt":"2024-03-11T09:14:09","slug":"nephrology-billing-compliance-and-regulations","status":"publish","type":"post","link":"https:\/\/medrbs.com\/nephrology-billing-compliance-and-regulations\/","title":{"rendered":"Adhering to Nephrology Billing Compliance and Regulations Guidelines 2024 Updated"},"content":{"rendered":"\n
The medical billing regulatory landscape is always changing. Staying current with the latest nephrology billing compliance and regulations is essential for any nephrology practice. This guide offers a detailed overview of the updates that impact how nephrology services are documented and billed.<\/p>\n\n\n\n
Furthermore, it provides a concise summary of the new standards, designed to help your nephrology practice stay compliant, avoid common billing errors, and maintain better financial health.<\/p>\n\n\n\n
Effective Nephrology billing<\/a> relies on Medicare guidelines that have specific rules for successful reimbursement. In order to ensure that your billing practices are compliant with regulations, follow these 3 tips below:<\/p>\n\n\n\n It’s important to stay informed about recent changes in Medicare policies. Regularly consulting the Centers for Medicare & Medicaid Services<\/a> (CMS) website can help you keep up with these changes. You may also subscribe to the relevant newsletters on the CMS website.<\/p>\n\n\n\n Proper documentation is a must for compliance in nephrology medical billing. Medicare requires detailed patient records that justify the necessity of each service billed. This includes diagnosis codes that match the treatment provided and clear notes on the patient\u2019s condition and treatment plan.<\/p>\n\n\n\n It\u2019s crucial to use the most current and accurate ICD-10 and CPT codes. Errors in coding can lead to claim rejections or denials, affecting your practice\u2019s revenue cycle. Training for staff on regular coding updates and conducting periodic audits can improve accuracy and compliance.<\/p>\n\n\n\n Accurate ICD-10 and CPT coding are fundamental to nephrology billing, ensuring a detailed and precise description of patient diagnoses. This level of detail is particularly crucial in a specialized field such as nephrology. To ensure effective billing, a deep understanding of commonly used codes and the strategies for their application is required.<\/p>\n\n\n\n One of the key strategies involves getting familiar with codes that are specific to nephrology. For instance, codes related to chronic kidney disease stages or dialysis treatments are frequently used and must be applied correctly to accurately represent the services provided. It is also essential to note the importance of specificity when choosing the codes, as this ensures the services are described precisely.<\/p>\n\n\n\n For a comprehensive list and descriptions of the CPT codes, checking the current year\u2019s CPT code book or the American Medical Association\u2019s resources<\/a> would be essential as codes and descriptions can be updated annually.<\/p>\n\n\n\n1. Stay up to Date With the Medicare Policy Changes<\/h3>\n\n\n\n
2. Meet Documentation Requirements<\/h3>\n\n\n\n
3. Apply Correct Nephrology Billing Codes<\/h3>\n\n\n\n
Accurate Icd-10 and Cpt Coding in Nephrology Billing Compliance<\/h2>\n\n\n\n
Most Common Nephrology Billing Codes<\/h3>\n\n\n\n
CPT Codes<\/th> Description<\/th><\/tr><\/thead> 90960<\/td> End-stage renal disease (ESRD) related services for dialysis less than a full month, for patients 20 years and older; 4 visits or more per month.<\/td><\/tr> 90961<\/td> ESRD-related services for dialysis less than a full month, for patients 20 years and older; 2-3 visits per month.<\/td><\/tr> 90962<\/td> ESRD-related services for dialysis less than a full month, for patients 20 years and older; 1 visit per month.<\/td><\/tr> 90966<\/td> ESRD-related services for home dialysis per full month, for patients 20 years and older.<\/td><\/tr> 90967<\/td> ESRD related services for home dialysis per full month, for patients under 2 years of age.<\/td><\/tr> 90968<\/td> ESRD-related services for home dialysis per full month, for patients 2-11 years of age.<\/td><\/tr> 90969<\/td> ESRD-related services for home dialysis per full month, for patients 12-19 years of age.<\/td><\/tr> 90970<\/td> ESRD-related services for dialysis per full month, for patients 20 years and older.<\/td><\/tr> 90989<\/td> Dialysis training complete, any mode (hemodialysis, peritoneal dialysis, continuous renal replacement therapy), for a patient, per session.<\/td><\/tr> 90993<\/td> Education programs for patient home hemodialysis or peritoneal dialysis.<\/td><\/tr> 90997<\/td> Hemodialysis services require additional medical supervision and care planning.<\/td><\/tr> 99221<\/td> Initial hospital care, per day, for the evaluation and management of a patient.<\/td><\/tr> 99223<\/td> Initial hospital care, per day, for the evaluation and management of a patient which requires complex medical decision-making.<\/td><\/tr> 93784<\/td> Ambulatory blood pressure monitoring, including recording, scanning analysis, interpretation, and report.<\/td><\/tr> 36245<\/td> Selective catheter placement, arterial system; each first-order abdominal, pelvic, or lower extremity artery branch.<\/td><\/tr> 75716<\/td> Angiography, extremities, bilateral, radiological supervision and interpretation.<\/td><\/tr> 82042<\/td> Albumin; quantitative, 24-hour collection or timed specimen.<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n