10-144-101 Me. Code R. § III-7

Current through 2024-46, November 13, 2024
Section 144-101-III-7 - Free-standing Dialysis Services

CODEHCPCS ***CODEDESCRIPTIONMAXIMUM ALLOWANCE
0821 90999 HEMODIALYSIS/COMPOSITE BY REPORT
0825 90993, 90989 SUPPORT SERVICES (HEMODIALYSIS BY REPORT
0831 90999 PERITONEAL DIALYSIS/COMPOSITE BY REPORT
0835 90993, 90989 SUPPORT SERVICES (IP) BY REPORT
0841 90999 CAPD/COMPOSITE BY REPORT
0845 90993, 90989 SUPPORT SERVICES/CAPD BY REPORT
0849 90945 OTHER CAPD DIALYSIS BY REPORT
0851 90999 CONTINUOUS CYCLING PERITONEAL DIALYSIS (CCPD) BY REPORT
0855 90993, 90989 SUPPORT SERVICES (CCPD) BY REPORT
0634 * EPO- INJECTION, EPOETIN ALFA, under 10,000 UNITS BY REPORT
0635 * EPO- INJECTION, EPOETIN ALFA, above 10,000 UNITS
0636** ARANESP- INJECTION, DARBEPOETIN ALFA, 1 MCG BY REPORT

* Providers must also put HCPCS Q4081 on claim form.

* * Providers must also put HCPCS JO882 on claim form.

*** These HCPCS codes will become effective upon implementation of MIHMS. (APA Office Note: This occurred on September°1, 2010.)

10-144 C.M.R. ch. 101, § III-7