The CPT codes for dialysis are primarily within the 90935–90999 range, including 90935 (hemodialysis), 90937 (complex hemodialysis), 90945 (peritoneal dialysis), 90960–90970 (home dialysis), and 90999 (unlisted dialysis procedure)
What is the CPT code for peritoneal dialysis?
Peritoneal dialysis is reported under CPT code 90945
This code covers dialysis procedures other than hemodialysis, including continuous ambulatory peritoneal dialysis (CAPD) and automated peritoneal dialysis (APD). Honestly, this is the most straightforward way to bill for peritoneal dialysis. You’ll use it when the physician handles the full assessment and ongoing management. Just make sure your notes clearly show why peritoneal dialysis makes more sense than other options for that patient.
What is the CPT code for home dialysis?
Home dialysis is billed using CPT codes 90960–90966, depending on patient age and frequency
Pick the right code based on whether the patient’s an adult (90966) or a child (90960–90965), plus how often they get treatments. For adults, you’ll report 90966 once per month. Only the doctor managing the patient’s overall care should submit the claim. The treatments themselves? Not billed separately.
What is procedure code 90999?
CPT code 90999 is the unlisted dialysis procedure code used when no specific code exists
Here’s the catch: you can only use this code with modifier -G5 if the patient gets seven or more dialysis sessions in a single month. And you’d better have detailed notes explaining why none of the standard codes fit. Facilities need to attach clinical notes to prove this unlisted code is truly necessary.
What is procedure code 90935?
CPT code 90935 is used to report inpatient or outpatient hemodialysis management
This code works for both ESRD and non-ESRD patients who need dialysis during acute renal failure. It covers evaluating, monitoring, and tweaking the dialysis prescription. Your documentation should spell out the patient’s condition and how they’re responding to treatment.
What is the ICD 10 code for dialysis?
The ICD-10-CM code for dialysis dependence is Z99.2
Use this code when a patient’s stuck on chronic dialysis because of end-stage renal disease (ESRD). It’s a billable code, so make sure you pair it with the right renal diagnosis—like N18.6. Your notes should back up why the patient needs ongoing dialysis support.
How is home dialysis billed?
Home dialysis is billed under CPT codes 90960–90966, with one monthly management fee submitted
Only the physician in charge of the patient’s care can bill the monthly management code. The actual dialysis treatments? Not billed separately. The service date is always the first day of the month, and your records need to show consistent assessment and care planning.
Who can bill CPT code 90837?
Psychologists and licensed clinical social workers can bill CPT code 90837 for 60-minute psychotherapy sessions
This code’s for sessions that run longer than the usual 45–50 minutes. You’ll need solid documentation showing why the extra time was medically necessary. Some insurers might ask for prior authorization before they’ll pay for it.
What is procedure code 99455?
CPT code 99455 is for work-related or medical disability examinations
It covers taking a medical history, doing an exam, making a diagnosis, and assessing functional capacity. For 2026, the Medicare fee is $236.64 when billed by the treating physician. Your notes should clearly link the clinical findings to any work restrictions or accommodations needed.
Does Medicare pay for 90989?
Medicare typically does not pay for CPT code 90989
Some commercial payers or government programs might cover it for home dialysis training, though. This code lets physicians bill for completed home training courses. Always double-check Medicare’s rules before you submit the claim—coverage can change fast.
What is CPT code 90937?
CPT code 90937 is used for hemodialysis requiring repeated evaluation and substantial revision of the prescription
Use this code when the patient’s condition demands frequent tweaks to their dialysis settings. It’s for intensive monitoring and highly personalized care. Without rock-solid documentation, you’ll struggle to justify billing this higher-level code.
What is Revenue Code 851?
Revenue Code 851 is used to bill for all types of dialysis services in hospital outpatient settings
This code covers the facility fee for dialysis treatments given to ESRD patients. It’s part of a group (821, 831, 841, 851) that includes all dialysis-related services. Just watch out—codes like 634 and 635 for Epogen don’t fit here.
What is outpatient dialysis?
Outpatient dialysis is the delivery of renal replacement therapy in a clinic or facility setting
This is the go-to approach for treating end-stage renal disease (ESRD). In 2026, about 388,000 Medicare patients will get dialysis in roughly 6,500 facilities nationwide. Outpatient centers give patients standardized monitoring and quick access to emergency care.
What is CPT code 90837 used for?
CPT code 90837 is used for 60-minute individual psychotherapy sessions
It’s longer than the standard 45–50 minute sessions covered by 90834. Providers need to explain why the extra time was medically necessary. Some insurers might ask for prior authorization or more justification before they’ll approve it.
What is dialysis used to treat?
Dialysis is used to treat kidney failure by removing waste, excess fluid, and toxins from the blood
It keeps electrolytes in balance, controls blood pressure, and stops uremia from causing bigger problems. Dialysis is a lifeline for patients with end-stage renal disease (ESRD) or acute kidney injury that needs temporary support. Without regular treatments, quality of life—and life itself—quickly falls apart.
What is the ICD 10 code for ESRD?
The ICD-10-CM code for end-stage renal disease is N18.6
This code documents irreversible kidney failure that requires dialysis or a transplant. It’s essential for proving medical necessity when billing dialysis services. Your records should confirm stage 5 chronic kidney disease (CKD) with dialysis dependence.
