Coding, Classification and Reimbursement

Physician reimbursement for renal evaluations

  • 1.  Physician reimbursement for renal evaluations

    Posted 01-03-2019 10:17
    I am posting this question for another member:

    Two years ago, I began working for the above practice. I was new to Nephrology. I am an AHIMA member and CCS-P Certified. PA Medicaid does not have Dialysis CPT codes on their fee schedule for physicians (Provider type--31) in either an outpatient or inpatient situation. Is there a way to bill correctly for physicians to be reimbursed for dialysis evaluations for PA Medicaid? My practice manager says there is not, and she has exhausted many possibilities. I was wondering if any other PA Nephrology coders have the same problem and if they have a solution. It seems that our providers should be reimbursed for the many dialysis services they provide to PA Medicaid patients. Any help would be appreciated.


    If you have skills in the physician reimbursement area, please comment.    Thank you for your time!

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    Laurie Johnson, MS, RHIA, FAHIMA
    AHIMA Approved ICD-10-CM/PCS Trainer
    Healthcare Consultant
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