Streamlining Billing in Nephrology: Key CPT Codes to Know

Nephrology is a discipline of internal medicine that detects and cures renal problems and gives the right treatment. It diagnoses and cures glomerulonephritis, chronic renal failure, kidney stones, and electrolyte problems. Nephrologists handle kidney diseases.

They work with other doctors to provide the best renal care. In addition to diagnosing and treating kidney issues, nephrologists advise on food and lifestyle changes to manage chronic disorders.

Patients collaborate on treatment strategies involving medication, dialysis, and kidney transplantation. Medical billing and coding for renal disorders are challenging because of the complexities associated with kidney diseases. Let’s examine some of Nephrology’s most essential billing codes.


Some common Nephrology CPT codes


90960: The doctor manages monthly care for 20-year-olds with end-stage renal disease (ESRD). This treatment requires four visits per month to the doctor.

90961: The explanation of the code remains the same as above, but the doctor must provide this level of care by seeing the patient at least two or three times per month.

90962: The code below is identical to the one previously explained. However, the doctor must meet with the patient monthly to offer this care.

90966: Patients 20 years or older with end-stage renal disease (ESRD) undergo monthly home dialysis while the physician monitors all medical treatments.

90967: A patient under two who has end-stage renal disease, or ESRD, has all daily services related to dialysis therapy managed by the physician for less than a month.

90968: The physician provides daily services related to dialysis therapy for less than an entire month to a patient who is 2 to 11 years old and has end-stage renal disease, or ESRD.

90969: The physician manages all dialysis services for a 12- to 19-year-old with ESRD for less than a month.

90999:  This code’s health and behavior assessment/intervention helps ESRD patients manage their medical issues and follow their dialysis schedules.

90970: This code treats a 20-year-old or older ESRD patient who undergoes daily dialysis.

90989: According to this code, the doctor instructs the patient and assists with dialysis procedures. This service provides extensive counseling and self-care teaching.

90993: This code describes the patient education programs available for home hemodialysis or peritoneal dialysis. A doctor’s office or dialysis clinic can provide these facilities, such as managing treatment, educating patients, and teaching them self-care.

90997: These codes refer to hemodialysis services that demand extra medical supervision and care planning. Medical case management must review hospitalizations, progress notes, and medications given to ESRD patients receiving dialysis.

99221: During an initial inpatient or observation care visit, when a patient is initially admitted to the clinic or placed under observation, the doctor assesses and manages their care.

A visit is considered to have taken place if there were no complex medical decisions to be made and the physician spent at least 40 minutes on a single date.

99223: This code has the same description as the one mentioned above, but it involves a visit that requires a significant amount of medical decision-making, or the provider spends a minimum of 75 minutes on a single date for the encounter.

93784: The doctor recommends ambulatory blood pressure monitoring, a method where a patient wears a device that automatically measures their blood pressure at regular intervals over 24 hours. The results are then stored for later review.

36245: The CPT code is used for placing a catheter selectively in every first-order branch of arteries in the abdomen, pelvis, or lower extremities in a vascular family.

75716: This code is for supervising and interpreting radiological procedures involving the placement of a catheter in both extremities.

82042: The lab analyst measures the quantity of albumin present in a specimen, whether collected at a specific time or randomly, and reports the measurement.

Conclusion

Partnering with a billing service provider who thoroughly understands nephrology is crucial. Their knowledge of the latest codes and regulations is critical to ensure that all billing is precise and in compliance with insurance policies. Our team can assist you with filing claims, following up on denied claims, and providing a detailed analysis of charges and payments.





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