Hemodialysis

Applies to:

All plans

Definition

Hemodialysis is a treatment for kidney failure that uses a machine to filter blood outside the body.

Home hemodialysis billing

  • For Priority Health Medicare Advantage plans, bill according to Medicare rules.
  • Bill CPT code 90999 with type of bill 72 and condition code 74.
  • Condition code 74 must be billed to indicate the dialysis was in the patient's home.
  • Payment for 90999 with condition code 74 is manually priced.

Refer to the Home Hemodialysis medical policy for more details.

Facility dialysis billing

  • For Priority Health Medicare Advantage plans, bill according to Medicare rules.
  • Bill for dialysis services in accordance with individual participation agreement.
  • 90999 billed to Priority Health secondarily will be paid according to the coordination of benefits.