Page 290 - Medicare Benefit Policy Manual

The HCPCS codes are:

• G0420: Face-to-face educational services related to the care of chronic kidney
disease; individual, per session, per one hour

• G0421: Face-to-face educational services related to the care of chronic kidney
disease; group, per session, per one hour

310.4 – Standards for Content
(Rev. 117; Issued: 12-18-09; Effective Date: 01-01-10; Implementation Date: 04-
05-10)

Medicare Part B covers KDE services, provided by a qualified person, which provide
comprehensive information regarding:

A. The management of comorbidities, including delaying the need for dialysis, which
includes, but is not limited to, the following topics:

• Prevention and treatment of cardiovascular disease,

• Prevention and treatment of diabetes,
• Hypertension management,
• Anemia management,
• Bone disease and disorders of calcium and phosphorus metabolism management,

• Symptomatic neuropathy management, and
• Impairments in functioning and well-being.

B. Prevention of uremic complications, which includes, but is not limited to, the
following topics:

• Information on how the kidneys work and what happens when the kidneys fail,
• Understanding if remaining kidney function can be protected, preventing disease
progression, and realistic chances of survival,
• Diet and fluid restrictions, and
• Medication review, including how each medication works, possible side effects
and minimization of side effects, the importance of compliance, and informed
decision making if the patient decides not to take a specific drug.

C. Therapeutic options, treatment modalities and settings, advantages and
disadvantages of each treatment option, and how the treatments replace the
kidney, including, but not limited to, the following topics:

• Hemodialysis, both at home and in-facility;