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Issue Number - Name
0076 - Evaluation and Management (E/M) Same Day as Dialysis
Review Type
Automated
Claim Type
All Physician/NPP specialties
Region and State
RAC 1-4
All States
Date Approved
2018-01-09

Description

Except when reported with modifier 25, payment for certain evaluation and management services is
bundled into the payment for dialysis services 90935, 90937, 90945, and 90947.

Affected Code(s)

  • 99201-99205, 99211-99215, 99221-99223, 99238-99239, and 99291-99292

Applicable Policy References

  • Title XVIII of the Social Security Act, Section 1833 
  • CMS Pub. 100-04, Medicare Claims Processing Manual, Chapter 8, Section 170(B)