Nephrology Billing and Coding Guidelines to Consider

Nephrology CPT and ICD 10 codes require a deep understanding of medical billing for kidney health treatments, complications, procedures, and diagnoses. Coding and submitting these correctly is particularly important to maximize your claim reimbursements 

A medical billing company, such as Benchmark Solutions, who has expertise in nephrology understands the meaning of these codes inside and out. This allows for the accurate identification of common codes such as those related to dialysis and chronic kidney diseases. Each of these identifiers necessitates documentation to reflect the severity, complexity, and specificity of your patient encounters. 

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Dialysis Billing Management

Nephrology practices often provide dialysis services, which also come with unique billing requirements. These may range from the appropriate use of modifier codes for dialysis procedures, to billing for dialysis supplies and equipment, and managing claims related to dialysis treatments. 

Chronic Kidney Diseases Billing Management

We understand chronic kidney diseases require ongoing monitoring, management, and coordination of care. That’s why our expertise can help your practice effectively manage claims such as laboratory tests, imaging studies, medications, and patient education programs. 

Documenting Care Complications

Complications can sometimes occur due to kidney related issues or even coexisting conditions. Documenting these complications during care is crucial for several reasons, including continuity of care, communication among healthcare providers, and for legal purposes. These especially must be documented with precise detail to ensure the correct coding, or it be coded at all to optimize your revenue cycle management.  

Medicare and Medicaid Compliance

Keeping up with Medicare and Medicaid policy changes is crucial for smooth billing procedures. Nephrology practices often have a large patient demographic made up of those covered by either Medicare or Medicaid, so it is especially important to understand their billing needs. 

These government run programs have specific billing rules and regulations one must follow to resolve claims, denials, and any issues in a timely manner. Staying up to date with these policy changes can be challenging to keep up with. Regular training and ongoing education on these programs are essential for staff members to navigate them effectively.  

Benchmark’s Rounds App Makes Your Nephrology Billing and Coding Management Easier

With our Benchmark PM add-on, the Benchmark Rounds app, you can easily access patient information from anywhere. Making your rounds through multiple hospitals and/or dialysis centers no longer needs to be a hassle when trying to keep billing records organized. Our app allows you to enter CPT and ICD 10 codes for billing and more with ease! 


Charge entry via Benchmark Rounds mobile app

Charge entry screen through the Benchmark PM mobile app.


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Benchmark Solutions Is Your Partner to Help You Follow Nephrology Billing and Coding Guidelines 

By using our experts’ resources and knowledge, nephrology practices can improve their medical billing and ensure consistent accuracy with their CPT and ICD 10 codes. Dialysis, chronic kidney diseases, care complications, and Medicare and Medicaid compliance are just a couple that we covered in this article, but we can help with so much more related to your nephrology medical billing. You’ll never have to worry about taking the time out of your day to research the most relevant news related to nephrology billing when you decide to work with us. Reach out today and let us take on the complexities so that you can spend more time caring for your patients. 

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