Table of Contents Previous Next Index

2012 Texas Medicaid Provider Procedures Manual

Clinics and Other Outpatient Facility Services Handbook : 6. Renal Dialysis Facility : 6.2 Services, Benefits, Limitations, and Prior Authorization

6.2 Services, Benefits, Limitations, and Prior Authorization
Renal dialysis is a benefit of Texas Medicaid for the following acute renal failure or end-stage renal disease (ESRD) diagnosis codes: 5845, 5846, 5847, 5848, 5849, 5851, 5852, 5853, 5854, 5855, 5856, and 5859.
Refer to:
Subsection 8.2.49, “Organ/Tissue Transplants” in Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook (Vol. 2, Provider Handbooks).
Subsection 3.2.5, “Organ and Tissue Transplant Services” in Hospital Services Handbook (Vol. 2, Provider Handbooks) for information on organ transplant and facility services.
Dialysis treatments are a benefit for clients in an inpatient or outpatient hospital or a renal dialysis facility according to the guidelines for outpatient maintenance dialysis approved through the CMS. Dialysis treatments may also be a benefit in the client’s home. Outpatient dialysis includes:

Texas Medicaid & Healthcare Partnership
CPT only copyright 2011 American Medical Association. All rights reserved.