Friday, June 4, 2010

CB, AX, CD AND G6 - End Stage Renal Disease (ESRD) Modifiers

End Stage Renal Disease (ESRD) Modifiers

CB Services ordered by a dialysis facility physician as part of the ESRD beneficiary's dialysis benefit.
AX Item furnished in conjunction with dialysis services.
CD AMCC test has been ordered by an ESRD facility or MCP physician that is part of the composite rate and is not separately billable
CE AMCC test has been ordered by an ESRD facility or MCP physician that is a composite rate test but is beyond the normal frequency covered under the rate and is separately reimbursable based on medical necessity
CF AMCC test has been ordered by an ESRD facility or MCP physician that is not part of the composite rate and is separately billable
EJ Subsequent claims for a defined course of therapy, e.g., EPO, sodium hyaluronate, infliximab.
G1 Most recent URR reading of less than 60
G2 Most recent URR reading of 60 to 64.9
G3 Most recent URR reading of 65 to 69.9
G4 Most recent URR reading of 70 to 74.9
G5 Most recent URR reading of 75 or greater
G6 ESRD patient for whom less than seven dialysis sessions have been provided in a month.

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