| CODE LIST | 
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- CODES:
 
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- CODE DESCRIPTION:    
Peritoneal dialysis including cannulation (procedure)
 
 
 
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- CODE DESCRIPTION:    
Automated peritoneal dialysis (procedure)
 
 
 
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- CODE DESCRIPTION:    
Peritoneal dialysis excluding cannulation (procedure)
 
 
 
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- CODE DESCRIPTION:    
Peritoneal dialysis (procedure)
 
 
 
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- CODE DESCRIPTION:    
Chronic peritoneal dialysis (procedure)
 
 
 
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- CODE DESCRIPTION:    
Continuous ambulatory peritoneal dialysis (procedure)
 
 
 
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- CODE DESCRIPTION:    
Continuous cycling peritoneal dialysis (procedure)
 
 
 
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- CODE DESCRIPTION:    
Intermittent peritoneal dialysis (procedure)
 
 
 
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- CODE DESCRIPTION:    
Tidal peritoneal dialysis (procedure)
 
 
 
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- CODE DESCRIPTION:    
Night-time intermittent peritoneal dialysis (procedure)
 
 
 
 
  
 
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- CODES:
 
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- CODE DESCRIPTION:    
Dialysis procedure other than hemodialysis (eg, peritoneal dialysis, hemofiltration, 
or other continuous renal replacement therapies), with single evaluation 
by a physician or other qualified health care professional
 
 
 
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- CODE DESCRIPTION:    
End-stage renal disease (ESRD) related services monthly, for patients 12-19 
years of age to include monitoring for the adequacy of nutrition, assessment 
of growth and development, and counseling of parents; with 2-3 face-to-face 
visits by a physician or other qualified health care professional per month
 
 
 
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- CODE DESCRIPTION:    
End-stage renal disease (ESRD) related services monthly, for patients 12-19 
years of age to include monitoring for the adequacy of nutrition, assessment 
of growth and development, and counseling of parents; with 1 face-to-face 
visit by a physician or other qualified health care professional per month
 
 
 
- 
- CODE DESCRIPTION:    
End-stage renal disease (ESRD) related services monthly, for patients 20 
years of age and older; with 4 or more face-to-face visits by a physician 
or other qualified health care professional per month
 
 
 
- 
- CODE DESCRIPTION:    
End-stage renal disease (ESRD) related services monthly, for patients 20 
years of age and older; with 2-3 face-to-face visits by a physician or 
other qualified health care professional per month
 
 
 
- 
- CODE DESCRIPTION:    
End-stage renal disease (ESRD) related services monthly, for patients 20 
years of age and older; with 1 face-to-face visit by a physician or other 
qualified health care professional per month
 
 
 
- 
- CODE DESCRIPTION:    
End-stage renal disease (ESRD) related services for home dialysis per full 
month, for patients younger than 2 years of age to include monitoring for 
the adequacy of nutrition, assessment of growth and development, and counseling 
of parents
 
 
 
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- CODE DESCRIPTION:    
End-stage renal disease (ESRD) related services for home dialysis per full 
month, for patients 2-11 years of age to include monitoring for the adequacy 
of nutrition, assessment of growth and development, and counseling of parents
 
 
 
- 
- CODE DESCRIPTION:    
End-stage renal disease (ESRD) related services for home dialysis per full 
month, for patients 12-19 years of age to include monitoring for the adequacy 
of nutrition, assessment of growth and development, and counseling of parents
 
 
 
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- CODE DESCRIPTION:    
End-stage renal disease (ESRD) related services for home dialysis per full 
month, for patients 20 years of age and older
 
 
 
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- CODE DESCRIPTION:    
End-stage renal disease (ESRD) related services for dialysis less than 
a full month of service, per day; for patients younger than 2 years of 
age
 
 
 
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- CODE DESCRIPTION:    
Dialysis procedure other than hemodialysis (eg, peritoneal dialysis, hemofiltration, 
or other continuous renal replacement therapies) requiring repeated evaluations 
by a physician or other qualified health care professional, with or without 
substantial revision of dialysis prescription
 
 
 
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- CODE DESCRIPTION:    
End-stage renal disease (ESRD) related services for dialysis less than 
a full month of service, per day; for patients 2-11 years of age
 
 
 
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- CODE DESCRIPTION:    
End-stage renal disease (ESRD) related services for dialysis less than 
a full month of service, per day; for patients 12-19 years of age
 
 
 
- 
- CODE DESCRIPTION:    
End-stage renal disease (ESRD) related services for dialysis less than 
a full month of service, per day; for patients 20 years of age and older
 
 
 
- 
- CODE DESCRIPTION:    
End-stage renal disease (ESRD) related services monthly, for patients younger 
than 2 years of age to include monitoring for the adequacy of nutrition, 
assessment of growth and development, and counseling of parents; with 4 
or more face-to-face visits by a physician or other qualified health care 
professional per month
 
 
 
- 
- CODE DESCRIPTION:    
End-stage renal disease (ESRD) related services monthly, for patients younger 
than 2 years of age to include monitoring for the adequacy of nutrition, 
assessment of growth and development, and counseling of parents; with 2-3 
face-to-face visits by a physician or other qualified health care professional 
per month
 
 
 
- 
- CODE DESCRIPTION:    
End-stage renal disease (ESRD) related services monthly, for patients younger 
than 2 years of age to include monitoring for the adequacy of nutrition, 
assessment of growth and development, and counseling of parents; with 1 
face-to-face visit by a physician or other qualified health care professional 
per month
 
 
 
- 
- CODE DESCRIPTION:    
End-stage renal disease (ESRD) related services monthly, for patients 2-11 
years of age to include monitoring for the adequacy of nutrition, assessment 
of growth and development, and counseling of parents; with 4 or more face-to-face 
visits by a physician or other qualified health care professional per month
 
 
 
- 
- CODE DESCRIPTION:    
End-stage renal disease (ESRD) related services monthly, for patients 2-11 
years of age to include monitoring for the adequacy of nutrition, assessment 
of growth and development, and counseling of parents; with 2-3 face-to-face 
visits by a physician or other qualified health care professional per month
 
 
 
- 
- CODE DESCRIPTION:    
End-stage renal disease (ESRD) related services monthly, for patients 2-11 
years of age to include monitoring for the adequacy of nutrition, assessment 
of growth and development, and counseling of parents; with 1 face-to-face 
visit by a physician or other qualified health care professional per month
 
 
 
- 
- CODE DESCRIPTION:    
End-stage renal disease (ESRD) related services monthly, for patients 12-19 
years of age to include monitoring for the adequacy of nutrition, assessment 
of growth and development, and counseling of parents; with 4 or more face-to-face 
visits by a physician or other qualified health care professional per month
 
 
 
 
  
 
 
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