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40.3.3.5 Hemodialysis, IPD, CCPD, and CAPD Training
Most self-dialysis training is given in an outpatient setting. While CAPD training itself usually does not justify inpatient status, CAPD training is covered when provided to an inpatient. It is reimbursed at the same rate as the facility's outpatient CAPD training rate. Payment for B-829, B-839, or B-859 consists of the facility's composite rate plus $20 per training session.
A client who is eligible for Medicaid may receive up to 18 days of training. Additional days of CAPD training (B-849) may be paid only when medical necessity is documented. Payment consists of the facility's composite rate plus $12 per training session.
CAPD training services and supplies provided by the dialysis facility include personnel services, parenteral items routinely used in dialysis, training manuals and materials, and routine CAPD laboratory tests.
No frequency limitation is applied to routine laboratory tests during the training period because these tests commonly are given during each day of training. Nonroutine laboratory tests performed during the training period require documentation of medical necessity.
It may be necessary to supplement the client's dialysis during CAPD training with IPD or hemodialysis because the client has not mastered the CAPD technique.
Three supplemental dialysis sessions are covered routinely. If more than three sessions are billed during the training, the claims must document the medical necessity.
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