The Enhanced Ambulatory Patient Groups (EAPG) system does not group dialysis services based on revenue code but instead assigns the appropriate EAPG based on Current Procedure Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) codes. For providers utilizing the EAPG system, please use the following billing guidelines when submitting claims for dialysis services.
Dialysis Treatment | Revenue Code | CPT Code | Units |
Hemodialysis | 0821 | 90935 or 90937 | |
Peritoneal Dialysis | 0841 or 0851 | 90945 or 90947 | |
Hemodialysis (Home) | 0821 | S9335 | |
Peritoneal (Home) | 0841 or 0851 | S9339 | |
Self-Dialysis | 0849 or 0859 | 90989 | 1 |
Self-Dialysis | 0849 or 0859 | 90993 | Number of treatments or sessions provided |
If CPT code 90999 is billed, the service will process as peritoneal dialysis. For additional information, please reference the Dialysis Services reimbursement policy.
