Is G0257 intended to be reserved for hemodialysis (rather than peritoneal)?

For a non-ESRD certified facility, Pub 104, Chapter 4 states 'G0257 - Unscheduled or emergency dialysis treatment for an ESRD patient in a hospital outpatient department that is not certified as an ESRD facility' - is to be used in certain circumstances (in connection with a dialysis-related procedure, following treatment for a medical emergency, or emergency dialysis for patients who would otherwise have to be admitted as inpatient for the hospital to receive payment). It also states circumstances under which 90935 should be used.

For HCPCS 90945, the Manual states only 'may be reported by a hospital paid under OPPS...'

Our thinking had been that non-ESRD certified facilities were required to report G0257 for all dialysis services (both hemo and peritoneal). We have recently received a recommendation to bill G0257 for outpatient hemodialysis and 90945 for outpatient peritoneal dialysis. What are other non ESRD facilities reporting?


Sign In to comment.