Continuous Cycling Peritoneal Dialysis

We have experienced an increasing number of CERT errors due to documentation requirements not being met. Below is a list of the most common reasons CERT determined there was insufficient documentation that caused improper payments for continuous cycling peritoneal dialysis services.

• Authenticated physician detailed orders to include annual standing orders. The orders must include the specific prescription including the modality, the number of cycles/exchange and total volume.
• Plan of care signed by physician and team members.
• Authenticated physician progress note.
• The lab results.
• Continuous cycling peritoneal dialysis flowsheets.

Related Content

• Centers for Medicare & Medicaid Services (CMS) Internet-Only Manual (IOM) Publication 100-02, Medicare Benefit Policy Manual, Chapter 11, Section 30 (Home Dialysis Items and Services), Section 30.1.A (Home Dialysis Hemodialysis and Peritoneal Support Services)
• CMS IOM Publication 100-04, Medicare Claims Processing Manual, Chapter 8, Section 80.4 (Calculating Payment for Continuous Ambulatory Peritoneal Dialysis (CAPD) and Continuous Cycling Peritoneal Dialysis (CCPD) Under the Composite rate)
• CMS IOM Publication 100-08, Medicare Program Integrity Manual, Chapter 3, Section 3.3.2.4.H (Signature Dating Requirements)