Nephrology CPT Codes and Modifiers for 2025
Mar 9, 2025
Nephrology is a complex specialty where providers frequently manage chronic kidney disease (CKD), dialysis, hypertension, and transplant care. With frequent rounding, outpatient consults, and care coordination, it’s critical to understand the correct CPT codes and modifiers for nephrology in 2025 to ensure accurate billing and compliance.
This guide outlines the most commonly used Nephrology CPT codes, modifiers, and ICD-10 pairings, plus tips to avoid denials and optimize reimbursement.
Evaluation & Management (E/M) Codes
| CPT Code | Description |
|---|---|
| 99202–99205 | New patient office visits (levels 2–5) |
| 99212–99215 | Established patient office visits (levels 2–5) |
| 99221–99223 | Initial hospital care (levels 1–3) |
| 99231–99233 | Subsequent hospital care |
| 99238–99239 | Hospital discharge services |
| 99495–99496 | Transitional care management (TCM), post-discharge |
Nephrology-Specific Services & Dialysis Management
| CPT Code | Description |
|---|---|
| 90935 | Hemodialysis, single evaluation |
| 90937 | Hemodialysis, repeated evaluations |
| 90945 | Peritoneal dialysis, one-time |
| 90947 | Peritoneal dialysis, repeated evaluations |
| 90951–90970 | Monthly ESRD-related services (age- and modality-based) |
| 90989 | Dialysis training, initial |
| 90993 | Dialysis training, additional |
Diagnostic Testing in Nephrology
| CPT Code | Description |
|---|---|
| 82043 | Microalbumin, urine |
| 82565 | Creatinine, serum |
| 84132 | Potassium, serum |
| 82306 | Vitamin D, 25-hydroxy |
| 84450 | Renin activity |
| 84520 | Urea nitrogen (BUN) |
Commonly Used Modifiers in Nephrology
| Modifier | Description |
|---|---|
| -25 | Significant, separately identifiable E/M on same day |
| -26 | Professional component only |
| -59 | Distinct procedural service |
| -76 | Repeat procedure by same provider |
| -77 | Repeat procedure by another provider |
| -95 | Telehealth service |
| -GC | Performed by resident under supervision |
Common ICD-10 Codes in Nephrology
| ICD-10 Code | Description |
|---|---|
| N18.3 | CKD stage 3 (moderate) |
| N18.4 | CKD stage 4 (severe) |
| N18.5 | CKD stage 5 |
| N18.6 | End-stage renal disease (ESRD) |
| I12.9 | Hypertensive CKD without heart failure |
| Z99.2 | Dependence on renal dialysis |
| Z94.0 | Kidney transplant status |
Nephrology Billing Tips for 2025
Final Thoughts
Nephrology billing requires a careful balance of compliance and detail. By using the correct Nephrology CPT codes and modifiers for 2025, your practice can improve cash flow, reduce denials, and stay audit-ready.
For informational purposes only.
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