Medicare Renal Dialysis Facility Manual
Manual Transmittals through Transmittal Number 95, dated May 2, 2003, are included in this update. As
new transmittals are included they will be identified on this page. Two other sites
may have more recent information. Program Transmittals
and Program Memoranda may
include documents that reflect current policies not yet incorporated into this
manual.
I. Introduction
This manual is intended for use by nonhospital operated renal dialysis facilities, which were included in references to "limited care facilities" in interim program instructions. These facilities may be located on or off the hospital (provider) premises and are engaged in furnishing maintenance dialysis services to established patients. In those instances where a nonhospital operated renal dialysis facility is located on the hospital premises, the administration of the facility must be separate from that of the hospital. Medicare approved nonhospital operated facilities are assigned identification numbers within the range of 2500- 2599. Approved renal dialysis facilities that are hospital operated must use the instructions that are included in the Medicare Hospital Manual (HIM-l0), rather than these instructions.
II. Function of Renal Dialysis Facility Manual
This manual contains a consolidation of all instructions necessary for properly
submitting renal dialysis bills for services to Medicare patients. In addition, since
patients often look to their treatment facility for general information about
Medicare or for Medicare coverage rules for services that may only be furnished by
transplant hospitals, general information has been included so that you may respond
to such general inquiries. More detailed information is available from the Medicare
fiscal intermediary, the local social security office, or the nearest Bureau of
Health Insurance Regional Office.
III. Organization
An overall table of contents appears at the front of this manual. In addition, a
partial table of contents precedes each of the four chapters. The four chapters are:
Chapter One - General information about Medicare coverage,
financing, and administration;
Chapter Two - Covered services and supplies usually involved
in treating patients with kidney disease;
Chapter Four - Reimbursement rules and information affecting allowable charges for renal dialysis services.
IV. Renal Dialysis Facility Manual Revisions
The manual is designed to accommodate new pages as further interpretations of the law and changes in policy and procedures are made. Accordingly, supplements and revised sections, pages, or chapters are issued as the need presents itself. Changed material is indicated in the left margin of a paper page with a vertical bar adjusted to the changed material. In the Internet manual changed text is in red span.
The revision transmittal sheet identifies new page numbers and the pages replaced, and summarizes the principal changes in the material being issued. When a major change in policy or procedures is involved, the background and effective date for the change is provided. If, at a later date, you wish to refer to the background explanation given on a transmittal sheet, you can identify the transmittal by its number which appears on each manual page. Transmittal sheets for electronic manual are in a separate directory within the manual directory (ts) structure. The file name will be followed by the ts # structure
V. Use of the Revision Transmittal Check Sheet
Immediately after the title page, a check sheet has been provided on which receipt
of revisions can be recorded. Revised manual transmittals should be filed in
transmittal number order to avoid discarding a more recent page in favor of an older
one.
If it appears that you have been skipped in the distribution of a particular
transmittal, keep in mind that the transmittals are not always distributed in strict
numerical sequence. Allow l0 working days after receipt of a higher numbered
transmittal before requesting a transmittal that you have not received.
VI. Supplementary Instructions
The Renal Dialysis Facility Manual system provides for the issuance of supplements
which permit speedy communication of information and instructions when legislation is
enacted amending the Social Security Act. Supplementary instructions are
distinguished by the letter prefix to the section number, e.g., A20l, and when
feasible, by the use to the section number, e.g., A20l, and when feasible, by the use
of colored paper. These supplements are filed at the end of each chapter for ease of
reference. As soon as practicable after issuance, supplement materials will be
incorporated into the permanent manual text.
VII. Intermediary as Information Source
Your intermediary will answer any questions you may have about Medicare policies and procedures. Facilities dealing directly with the Social Security Administration may direct questions to the Regional Medicare Director for reply or refer them to the Provider Liaison and Appeals Branch of the Division of Direct Reimbursement.
VIII. System requirements for accessing and reading manuals
The basic requirements for accessing the manual electronically is an Internet connection with a Web Browsers, for connection to the HCFA Intranet.
Text is published in hypertext markup language (HTML), the standard language for Internet text communication. Forms are published in inter laced GIF 89a in each format.
You may save for you own use any file or files within the manual, using you Web Browser save procedure. Most current Internet Browser will provide files acceptable to the major Word Processing programs.
In place of a written index, a keyword electronic search facility is included.
IX. Navigation Procedures
From the manual general table of contents (see section three above)you can view the various chapters by left clicking the mouse on the hypertext link on the chapter you wish to access. Also, you may backup to your previous location with the back feature of your Browser, or go to the manual general table of contents by going to the specified text at the bottom of the table of contents of each chapter.
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