(Medicare Benefit Policy Manual)

The excising hospit al plays an important part in the national organ procurement effort.  Most of these hospitals are community hospitals and neither excise kidneys on a regular basis nor perform transplants.  A hospital that excises but does not transplant kidneys must be certified to participate in the Medicare program.  Where the hospital is not participating in the Medicare program, organs may be accepted from it only if they cannot be obtained from any other source.   A hospital that excises but does not transplant kidneys  may perform excisions on cadavers or on live donors; however, regardless of the vital status of the donor, most of the hospital services utilized in the excision are the same.      Transmittals Issued for this Chapter    Rev #  Issue Date  Subject  Impl Date  CR#  R257BP  03/01/2019 Update to Publication 100- 02 Provide Language -Only Changes for the New Medicare Card Project  04/01/2019  11170  R254BP  12/13/2018 Implementation of Changes in the End -Stage Renal Disease (ESRD) Prospective Payment System (PPS) and Payment for Dialysis Furnished for Acute Kidney Injury (AKI) in ESRD Facilities for Calendar Year (CY) 2019   01/07/2019  11021  R250BP  10/25/2018 Implementation of Changes in the End -Stage Renal Disease (ESRD) Prospective Payment System (PPS) and Payment for Dialysis Furnished for Acute Kidney Injury (AKI) in ESRD Facilities for Calendar Year (CY) 2019 01/07/2019  11021  R245BP  08/03/2018 System Changes to Implement Epoetin Alfa Biosimilar, Retacrit for End Stage Renal Disease (ESRD) and Acute Kidney Injury (AKI) Claim s 01/07/2019  10839  R244BP  07/20/2018 Internet Only Manual (IOM) Update to Publication 100- 02, Chapter 11 -  End Stage Renal Disease (ESRD), Section 100 10/23/2018  10809  R240BP  01/19/2018 Internet Only Manual (IOM) Update to Pub. 100-02, Chapter 11 -  End Stage Renal Disease (ESRD), Section 100 02/20/2018  10366  R224BP  06/03/2016 Update to Pub. 100- 02, Chapter 11 End- Stage Renal Disease (ESRD) for Calendar Year (CY) 2016  09/06/2016  9541 R219BP  01/13/2016 Calendar Year (CY) 2016 Eligibility Changes to the End- Stage Renal Disease (ESRD) Prospective Payment System (PPS) Low -Volume Payment Adjustment (LVPA)  01/22/2016  9478  R218BP  01/08/2016 Calendar Year (CY) 2016 Eligibility Changes to the End- Stage Renal Disease (ESRD) Prospective Payment System (PPS) Low -Volume Payment Adjustment (LVPA)  Rescinded and replaced by Transmittal 219 01/22/2016  9478 R200BP  12/02/2014 Implementation o f Changes in the End -Stage Renal Disease Prospective Payment System (ESRD PPS) for Calendar Year (CY) 2015  01/05/2015  8978 R199BP  11/14/2014 Implementation of Changes in the End -Stage Renal Disease Prospective Payment System (ESRD PPS) for Calendar Year (CY) 2015  Rescinded and replaced by Transmittal 200 01/05/2015  8978 R197BP  10/24/2014 Clarification of the End Stage Renal Disease (ESRD) Prospective Payment System (PPS) Low Volume Adjustment  01/05/2015  8898 R195BP  10/102014 Clarification of the End Stage Renal Disease (ESRD) Prospective Payment System (PPS) Low Volume Adjustment  Rescinded and replaced by Transmittal 197  01/12/2015  8898 R177BP  12/13/2013 Implementation of Changes in the End -Stage Renal Disease Prospective Payment System (ESRD PPS) for Calendar Year (CY) 2014  01/06/2014  8472 R174BP  11/29/2013 Implementation of Changes in the End -Stage Renal Disease Prospective Payment System (ESRD PPS) for Calendar Year (CY) 2014  Rescinded and replaced by Transmittal 177 01/06/2014  8472 R171BP  06/07/2013 Implementation of the End Stage Renal Disease (ESRD) Prospective Payment Sys tem (PPS)  09/09/2013  8261 R148BP  01/28/2011 Billing for Donor Post -Kidney Transplant Complication Services  04/02/2012  7523  R136BP  01/28/2011 Clarification of Existing Policy Regarding Items and Services Included Under End Stage Renal Disease (ESRD) Composite Payment Rate 02/25/ 2011  7312 R98BP  12/12/2008 Implementation of Changes in End Stage Renal Disease (ESRD) Payment for Calendar Year 2009  01/05/2009  6216 R83BP  02/15/2008 Clinical Lab: New Automated Test for the AMCC Panel Payment Algorithm 07/07/2008  5874 R67BP  03/09/2007 2007 Update to the End Stage Renal Disease Composite Payment Rates  04/02/2007  5535 R61BP  11/24/2006 Implementation of Changes in End Stage Renal Disease (ESRD) Payment for Calendar Year (CY) 2007  01/02/2007  5407 R50BP  06/02/2006 Immunosuppressive Therapy For Kidney Transplant  07/03/2006  4143 R44BP  02/10/2006 Update to the ESRD Composite Payment Rate 02/13/2006  4291 R35BP  06/03/2005 Automated Multi- Channel Chemistry (AMCC) for Continuous Ambulatory Peritoneal Dialysis (CAPD) and Non -CAPD Patients  07/05/2005  3802 R27BP  11/23/2004 New ESRD Composite Payment Rates Effective January 1, 2005 01/03/2005  3554 R08BP  03/05/2004 Policy Changes to Reflect Billing for Darbepoetin Alfa and Epoetin  04/05/2004  2984 R07BP  02/20/2004 Restoring Composite Rate Exceptions for Pediatric Facilities Under the ESRD Composite Rate System  04/01/2004  3119 R01BP  10/01/2003 Introduction to the Benefit Policy Manual  N/A N/A Back to top of Chapter