Infusion centers manage a wide variety of treatments—from antibiotics and hydration to chemotherapy and biologic therapies. Correct use of Infusion CPT codes and modifiers for 2025 is crucial to ensure accurate billing, maximize revenue, and stay compliant with complex payer rules.

Initial Infusion Services

CPT Code	Description
96365	IV infusion, therapy/prophylaxis/diagnosis, initial, up to 1 hour
96360	Hydration infusion, initial, up to 1 hour
96413	Chemotherapy infusion, initial, up to 1 hour
96401	Chemotherapy subcutaneous or intramuscular administration

Additional Hours and Concurrent Infusions

CPT Code	Description
96366	Each additional hour, therapeutic infusion
96361	Each additional hour, hydration infusion
96415	Each additional hour, chemotherapy infusion
96368	Concurrent infusion during primary service

IV Push and Injection Services

CPT Code	Description
96374	Therapeutic IV push, single/initial substance
96375	Each additional IV push, sequential substance
96372	Therapeutic injection, IM or subcutaneous

Common Drug Administration Scenarios

Scenario	Example	Coding Approach
Antibiotic infusion	IV ceftriaxone	96365 (+96366 if >1 hr)
Hydration infusion	IV normal saline	96360 (+96361 if >1 hr)
Chemotherapy infusion	IV rituximab	96413 (+96415 if >1 hr)
IV push steroid	IV methylprednisolone	96374

Infusion Billing Modifiers

Modifier	Description
-59	Distinct procedural service
-91	Repeat lab or diagnostic test
-25	Significant, separately identifiable E/M service
-JW	Drug amount discarded
-JG	Drug acquired at 340B discounted price

Common ICD-10 Codes for Infusion Centers

ICD-10 Code	Description
Z51.11	Encounter for chemotherapy
Z51.12	Encounter for immunotherapy
Z51.81	Encounter for therapeutic drug administration
E86.0	Dehydration
J44.1	COPD with acute exacerbation
M05.79	Rheumatoid arthritis with organ involvement
R50.9	Fever, unspecified

Infusion Billing Tips for 2025

• Bill chemotherapy first, then therapeutic infusions, then hydration.
• Use -59 when services are distinct (e.g., separate IV lines or substances).
• Document infusion start/stop times carefully to support duration codes.
• Always use -JW for drug wastage reporting where applicable.
• Hydration must be medically necessary and well-documented.

Final Thoughts

Infusion billing is detailed and time-sensitive. Correct use of Infusion CPT codes and modifiers for 2025 ensures you capture every minute of service, justify all billed medications, and optimize revenue while maintaining strict compliance standards.

Urgent care centers handle a wide range of patient needs—from minor injuries and infections to diagnostic testing and laceration repairs. Given the fast-paced environment, accurate use of Urgent Care CPT codes and modifiers for 2025 is critical to ensure proper reimbursement and avoid billing errors.

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)

Common In-Office Procedures

CPT Code	Description
12001–12007	Simple wound repair (lacerations, 2.5–7.5 cm)
11730	Removal of nail plate
20610	Arthrocentesis, major joint
10060	Incision and drainage of abscess
29580	Application of Unna boot
96372	Therapeutic injection, IM or subcutaneous

Diagnostic Testing and Screenings

CPT Code	Description
87804	Rapid influenza test
87811	COVID-19 rapid test
81002	Urinalysis, non-automated
87081	Cultures, screen only
36415	Routine venipuncture
93000	EKG with interpretation and report

Immunizations and Administration

CPT Code	Description
90471	First immunization administration
90472	Each additional vaccine administered
90715	Tetanus, diphtheria, acellular pertussis (Tdap) vaccine
90686	Influenza virus vaccine (quadrivalent)

Urgent Care Billing Modifiers

Modifier	Description
-25	Significant, separately identifiable E/M service
-59	Distinct procedural service
-76	Repeat procedure by same provider
-95	Telehealth service via real-time audio and video
-52	Reduced services

Common ICD-10 Codes in Urgent Care

ICD-10 Code	Description
J06.9	Acute upper respiratory infection
R50.9	Fever, unspecified
S91.002A	Open wound of foot, initial encounter
S51.809A	Laceration of forearm, initial encounter
N39.0	Urinary tract infection, site not specified
J02.9	Acute pharyngitis, unspecified
M54.5	Low back pain
R07.9	Chest pain, unspecified

Urgent Care Billing Tips for 2025

• Use -25 when minor procedures and E/M services occur the same day.
• Correctly apply wound repair codes based on length and complexity.
• Document test results and necessity clearly for lab services.
• For telehealth urgent care, always append modifier -95.
• Ensure proper designation of new vs. established patients per CPT definitions.

Final Thoughts

Urgent care billing needs to be efficient and accurate to reflect the high patient volume and variety of services provided. Mastering Urgent Care CPT codes and modifiers for 2025 ensures smoother revenue cycles, faster reimbursement, and compliance with payer requirements—without slowing down your clinic’s fast pace.

OB/GYN practices handle everything from preventive care and pregnancy management to surgeries and menopause counseling. To ensure full reimbursement and minimize denials, it’s critical to use the correct OB/GYN CPT codes and modifiers for 2025.

This guide covers essential Evaluation & Management (E/M), prenatal care, procedures, and diagnostic testing codes, plus common modifiers and ICD-10 pairings.

Evaluation & Management (E/M) Codes

CPT Code	Description
99202–99205	New patient office visits
99212–99215	Established patient office visits
99221–99223	Initial hospital care
99231–99233	Subsequent hospital care
99238–99239	Hospital discharge services

Obstetric Services

CPT Code	Description
59400	Routine OB care (antepartum, delivery, postpartum)
59409	Vaginal delivery only
59410	Vaginal delivery with postpartum care
59510	Routine cesarean care
59514	Cesarean delivery only
59515	Cesarean with postpartum care
59610	VBAC vaginal delivery
59618	VBAC cesarean delivery

Common Gynecological Procedures

CPT Code	Description
57500	Cervical biopsy
58100	Endometrial biopsy
58300	IUD insertion
58301	IUD removal
58120	Dilation and curettage (D&C)
57454	Colposcopy with biopsy and ECC
58558	Hysteroscopy with biopsy or polypectomy
58661	Laparoscopic removal of adnexal structures

Diagnostic Tests and Screenings

CPT Code	Description
81025	Urine pregnancy test
76801	Obstetric ultrasound, first trimester
76805	Obstetric ultrasound, second/third trimester
76856	Pelvic ultrasound, non-obstetric
87624	HPV testing
88175	Automated Pap smear with rescreen

OB/GYN Billing Modifiers

Modifier	Description
-25	Separate E/M on same day as procedure
-59	Distinct procedural service
-76	Repeat procedure by same provider
-77	Repeat procedure by another provider
-24	Unrelated E/M during global period
-51	Multiple procedures
-TC	Technical component
-26	Professional component

Common ICD-10 Codes for OB/GYN

ICD-10 Code	Description
Z34.91	Supervision of normal pregnancy, unspecified trimester
N80.9	Endometriosis, unspecified site
N84.0	Polyp of corpus uteri
N92.5	Other irregular menstruation
Z12.4	Screening for cervical cancer
N93.9	Abnormal uterine bleeding, unspecified
Z30.09	General contraception counseling

OB/GYN Billing Tips for 2025

• Use global maternity care codes accurately based on care provided.
• Apply -25 when E/M is performed in addition to a procedure.
• Use -59 cautiously to separate bundled services.
• Ensure correct ICD-10 diagnosis coding for screenings vs. diagnostics.

Final Thoughts

OB/GYN billing can get complicated quickly, with bundled maternity care, preventive visits, and procedures often performed together. By staying current on OB/GYN CPT codes and modifiers for 2025, practices can avoid denials, reduce audits, and streamline reimbursement while focusing on excellent patient care.

Internal medicine providers are the cornerstone of adult healthcare, diagnosing and managing chronic illnesses, preventive care, acute conditions, and complex cases. With such a broad scope, it’s crucial to stay current on Internal Medicine CPT codes and modifiers for 2025 to ensure accurate billing and maximize 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
99231–99233	Subsequent hospital care
99238–99239	Hospital discharge services
99495–99496	Transitional care management

Preventive Medicine Services

CPT Code	Description
99385–99387	Initial preventive visit (new patient)
99395–99397	Periodic preventive visit (established patient)
G0402	Medicare Welcome to Medicare Visit
G0438	Medicare Annual Wellness Visit, initial
G0439	Medicare Annual Wellness Visit, subsequent

Common In-Office Procedures

CPT Code	Description
36415	Routine venipuncture (blood draw)
81002	Urinalysis, non-automated
87804	Rapid influenza test
87811	COVID-19 rapid antigen test
11719	Trimming of non-dystrophic nails
20610	Arthrocentesis, major joint
90471	Immunization administration (first vaccine)
90472	Each additional vaccine administration

Internal Medicine Modifiers

Modifier	Description
-25	Significant, separately identifiable E/M service
-59	Distinct procedural service
-76	Repeat procedure by same provider
-24	Unrelated E/M during post-op period
-95	Telehealth services
-33	Preventive service, ACA compliant

Common ICD-10 Codes in Internal Medicine

ICD-10 Code	Description
I10	Essential hypertension
E11.9	Type 2 diabetes mellitus without complications
E78.5	Hyperlipidemia, unspecified
J06.9	Acute upper respiratory infection, unspecified
J18.9	Pneumonia, unspecified
Z00.00	General adult medical exam without abnormal findings
R07.9	Chest pain, unspecified
F41.1	Generalized anxiety disorder
R53.83	Other fatigue

Internal Medicine Billing Tips for 2025

• Use -25 appropriately when billing an E/M service plus a procedure.
• Document separate problem-focused vs. preventive work clearly if both are billed.
• Use ICD-10 codes that support medical necessity for each CPT billed.
• Review payer telehealth policies—many services remain eligible in 2025.

Final Thoughts

Internal medicine providers manage a broad range of conditions, and billing must capture that complexity. By mastering Internal Medicine CPT codes and modifiers for 2025, practices can maximize revenue, improve compliance, and reduce audit risk while providing exceptional care.

Ophthalmology practices perform a wide variety of services—from routine eye exams and imaging to complex surgical procedures. To ensure your claims are paid promptly and accurately, you need to stay current with CPT codes and modifiers for 2025.

This guide outlines the most commonly used Ophthalmology CPT codes and modifiers, plus coding tips to help your billing team stay compliant and maximize reimbursements.

Evaluation & Management (E/M) Codes

CPT Code	Description
92002	New patient, intermediate eye exam
92004	New patient, comprehensive eye exam
92012	Established patient, intermediate eye exam
92014	Established patient, comprehensive eye exam
99202–99205	New patient E/M (levels 2–5)
99212–99215	Established patient E/M (levels 2–5)

Diagnostic Testing & Imaging

CPT Code	Description
92133	OCT of optic nerve, unilateral or bilateral
92134	OCT of retina, unilateral or bilateral
92083	Visual field exam, extended
92201	Extended ophthalmoscopy, new patient
92202	Extended ophthalmoscopy, established patient
92250	Fundus photography
92060	Sensorimotor exam
76514	B-scan ocular ultrasound
92285	External ocular photography

Common Ophthalmic Procedures

CPT Code	Description
67028	Intravitreal injection of medication
65855	Laser trabeculoplasty (glaucoma)
66761	YAG laser capsulotomy
66984	Cataract surgery with IOL
67840	Excision of lesion on eyelid
68761	Closure of lacrimal punctum by plug
65435	Removal of corneal epithelium

Commonly Used Modifiers in Ophthalmology

Modifier	Description
-25	Significant, separately identifiable E/M on same day
-50	Bilateral procedure
-RT / -LT	Right or left eye
-24	Unrelated E/M during post-op period
-57	Decision for surgery
-79	Unrelated procedure during post-op period
-55	Post-op care only

Common ICD-10 Codes in Ophthalmology

ICD-10 Code	Description
H25.13	Age-related nuclear cataract, bilateral
H40.11X3	Primary open-angle glaucoma, severe stage
H52.13	Myopia, bilateral
H53.003	Unspecified amblyopia, bilateral
H35.31	Nonexudative age-related macular degeneration
H10.9	Unspecified conjunctivitis
H43.1	Vitreous degeneration

Ophthalmology Coding Tips for 2025

• Use eye codes or E/M codes appropriately: Choose based on complexity and content of the visit.
• Include laterality when required: RT/LT modifiers are crucial.
• Use -25 carefully: Make sure documentation supports billing E/M alongside minor procedures.
• Watch global periods: Especially after surgeries like cataracts or YAG.

Final Thoughts

Billing in ophthalmology can get complex fast—especially when dealing with imaging, surgical procedures, and post-op rules. Using the correct Ophthalmology CPT codes and modifiers in 2025 helps reduce denials, get paid faster, and keep your practice compliant.

Dermatology billing involves a mix of office visits, biopsies, lesion removals, skin cancer treatments, and cosmetic procedures. With such a wide variety of services, it’s crucial to stay up to date on CPT codes and modifiers for dermatology in 2025 to avoid denials and secure full reimbursement.

Evaluation & Management (E/M) Codes

CPT Code	Description
99202–99205	New patient office visits
99212–99215	Established patient office visits
99241–99245	Consultations (payer dependent)

Skin Biopsies

CPT Code	Description
11102	Tangential biopsy, first lesion
11103	Each additional lesion (with 11102)
11104	Punch biopsy, first lesion
11105	Each additional lesion (with 11104)
11106	Incisional biopsy, first lesion
11107	Each additional lesion (with 11106)

Destruction of Benign, Premalignant, or Malignant Lesions

CPT Code	Description
17000	First premalignant lesion (e.g., actinic keratosis)
17003	Each additional premalignant lesion (up to 14)
17004	15+ premalignant lesions
17110	1–14 benign lesions (e.g., warts)
17111	15+ benign lesions

Removal of Malignant Skin Lesions

Use codes 11600–11646 for excision of malignant lesions and 11400–11446 for benign lesions. Codes are based on location and total size including margins.

Repairs & Wound Closures

Codes depend on complexity of closure:

• 12001–12021: Simple repairs
• 12031–12057: Intermediate repairs
• 13100–13160: Complex repairs

Common Dermatology Modifiers

Modifier	Description
-25	Significant, separately identifiable E/M
-59	Distinct procedural service
-76	Repeat procedure by same provider
-RT / -LT	Right or left side
-51	Multiple procedures
-24	Unrelated E/M during global period
-79	Unrelated procedure during post-op period

Common Dermatology ICD-10 Codes

ICD-10 Code	Description
L57.0	Actinic keratosis
D23.5	Benign neoplasm of skin, trunk
C44.319	Basal cell carcinoma, unspecified location
C44.01	Squamous cell carcinoma of lip
L82.1	Inflamed seborrheic keratosis
D48.5	Neoplasm of uncertain behavior, skin
Z12.83	Encounter for skin cancer screening

Dermatology Billing Tips for 2025

• Use -25 for same-day E/M and procedures (clearly documented).
• Include margins in total excision size for coding accuracy.
• Use -59 when bundling rules apply—such as biopsy plus destruction.
• Be aware of global periods—most excisions have 10-day global windows.
• Document number, type, and diagnosis of lesions treated.

Final Thoughts

Dermatology billing requires accuracy, especially when procedures and office visits are performed together. Using the correct Dermatology CPT codes and modifiers for 2025 ensures proper payment and minimizes audit risk—whether you’re managing skin cancer, treating warts, or performing cosmetic procedures.

Sleep centers play a critical role in diagnosing and managing conditions like obstructive sleep apnea, insomnia, narcolepsy, and restless leg syndrome. But with rapidly evolving technology and payer rules, proper coding is essential. This guide includes the most relevant Sleep Center CPT codes and modifiers for 2025, including polysomnography (PSG), home sleep apnea tests (HSAT), and follow-up services.

Diagnostic Sleep Studies (Polysomnography)

CPT Code	Description
95810	PSG, attended, with sleep staging, no CPAP
95811	PSG, attended, with CPAP/BiPAP titration
95782	PSG, pediatric, no CPAP
95783	PSG, pediatric, with CPAP

Home Sleep Apnea Testing (HSAT)

CPT Code	Description
95800	Sleep study, unattended, cardio-respiratory
95801	Sleep study, unattended, limited parameters
95806	HSAT, unattended, 3+ parameters
G0398	Home sleep test with type II monitor
G0399	Home sleep test with type III monitor
G0400	Home sleep test with type IV monitor

MSLT & MWT

CPT Code	Description
95805	MSLT or MWT, full day sleepiness testing

Follow-Up & Management Services

CPT Code	Description
99441–99443	Telephone E/M (5–30+ min)
99457	Remote monitoring (e.g., CPAP adherence), 20+ min
99458	Each additional 20 minutes
99212–99215	Established patient E/M visits
G0402 / G0438 / G0439	Medicare wellness visits

Modifiers for Sleep Studies

Modifier	Description
-26	Professional component (interpretation only)
-TC	Technical component (equipment/staff)
-25	Separate E/M on same day as study
-52	Reduced service (e.g., incomplete study)
-59	Distinct procedural service
-91	Repeat diagnostic test

Common ICD-10 Codes for Sleep Centers

ICD-10 Code	Description
G47.33	Obstructive sleep apnea
G47.30	Sleep apnea, unspecified
G47.00	Insomnia, unspecified
G47.10	Hypersomnia, unspecified
G47.419	Narcolepsy without cataplexy
R06.83	Snoring
R06.89	Other abnormal breathing
Z01.89	Special exam (e.g., consult)

Sleep Center Coding Tips for 2025

• Use -26/-TC when billing separately for physician vs. lab components.
• Use -52 for early term or incomplete studies (e.g., technical failures).
• Repeat testing (e.g., HSAT) requires clear documentation for medical necessity.
• Document all parameters recorded in PSG and HSAT for compliance.

Final Thoughts

Sleep centers must navigate strict documentation, coverage policies, and coding guidelines. With this guide to Sleep Study CPT codes and modifiers for 2025, your practice can avoid denials and ensure accurate reimbursement—whether you’re conducting PSGs, interpreting HSATs, or managing long-term CPAP use.

Pathology plays a critical role in diagnosis and disease monitoring—from tissue biopsies and Pap smears to molecular testing and autopsy services. To ensure timely and accurate reimbursement, labs and providers must stay current with Pathology CPT codes and modifiers for 2025.

Common Clinical Pathology Codes

CPT Code	Description
80050	General health panel
80053	Comprehensive metabolic panel
81001	Urinalysis, automated, with microscopy
82043	Microalbumin, urine
82565	Creatinine, serum
83036	Hemoglobin A1c
84443	Thyroid-stimulating hormone (TSH)
85025	Complete blood count (CBC), automated with diff
85610	Prothrombin time (PT)
86308	H. pylori antibody test

Anatomic Pathology Codes

CPT Code	Description
88300	Gross exam only
88304	Surgical pathology, level III
88305	Surgical pathology, level IV
88307	Surgical pathology, level V
88309	Surgical pathology, level VI
88142	Pap smear, manual screening
88175	Pap smear, automated w/manual rescreen
88341	Immunohistochemistry, each additional antibody
88360	Morphometric analysis, quantitative
88365	In situ hybridization (e.g., FISH)

Molecular Pathology & Genetic Testing

CPT Code	Description
81210	BRAF gene analysis
81235	EGFR gene analysis
81314	KRAS gene mutation analysis
81445	Oncology targeted panel (5–50 genes)
81450	Exome sequencing, disease-specific
81479	Unlisted molecular pathology procedure

Common Modifiers in Pathology Billing

Modifier	Description
-26	Professional component only
-TC	Technical component only
-90	Reference (outside) laboratory
-91	Repeat diagnostic lab test
-59	Distinct procedural service
-77	Repeat test by another provider
-92	Alternative platform testing

Common ICD-10 Codes in Pathology

ICD-10 Code	Description
D50.9	Iron deficiency anemia, unspecified
E11.9	Type 2 diabetes without complications
C50.911	Malignant neoplasm, right breast
N63	Unspecified breast lump
R97.2	Elevated PSA
R94.5	Abnormal breast imaging findings
Z12.4	Screening for cervical cancer
Z12.11	Screening for colon cancer
Z13.0	Screening for diabetes

Pathology Billing Tips for 2025

• Use -26 and -TC correctly—never together.
• Use -91 only for medically necessary repeats (not quality control).
• Ensure ICD-10 codes justify the test for medical necessity.
• Some genetic tests require prior authorization—verify with payers.
• Group related tests when applicable to avoid unbundling issues.

Final Thoughts

Whether your lab is analyzing biopsies, running blood panels, or performing genetic sequencing, accuracy in coding ensures fair payment and audit readiness. Use this guide to stay current on Pathology CPT codes and modifiers for 2025 and optimize billing for every test, tissue, and report.

Hospitalists are the backbone of inpatient care—managing admissions, daily rounds, critical care, discharges, and transitions. With a fast-paced workflow and frequent handoffs, hospitalist billing needs to be precise and well-documented.

This guide includes the most commonly used Hospitalist CPT codes and modifiers for 2025, plus ICD-10 codes and billing tips to help prevent denials and ensure full reimbursement.

Initial Hospital Care

CPT Code	Description
99221	Initial hospital care, level 1
99222	Initial hospital care, level 2
99223	Initial hospital care, level 3

Subsequent Hospital Visits (Daily Rounds)

CPT Code	Description
99231	Subsequent hospital care, level 1
99232	Subsequent hospital care, level 2
99233	Subsequent hospital care, level 3

Hospital Discharge Services

CPT Code	Description
99238	Hospital discharge, 30 minutes or less
99239	Hospital discharge, more than 30 minutes

Observation Care

CPT Code	Description
99234	Observation/inpatient same day, level 1
99235	Observation/inpatient same day, level 2
99236	Observation/inpatient same day, level 3
99218–99220	Initial observation care
99224–99226	Subsequent observation care
99217	Observation discharge

Critical Care Services

CPT Code	Description
99291	Critical care, first 30–74 minutes
99292	Each additional 30 minutes

Transition of Care & Prolonged Services

CPT Code	Description
99495	TCM, moderate complexity, seen within 14 days
99496	TCM, high complexity, seen within 7 days
99417	Prolonged E/M time beyond 75 minutes

Modifiers Commonly Used by Hospitalists

Modifier	Description
-25	Significant, separately identifiable E/M on same day
-24	Unrelated E/M during post-op period
-AI	Principal physician of record
-57	Decision for surgery
-76	Repeat service by same provider
-95	Telehealth service (if applicable)

Common ICD-10 Codes Used in Hospital Medicine

ICD-10 Code	Description
J18.9	Pneumonia, unspecified
I10	Essential hypertension
N17.9	Acute kidney failure
R07.9	Chest pain, unspecified
E11.9	Type 2 diabetes without complications
Z51.89	Aftercare, other specified
R41.82	Altered mental status, unspecified

Hospitalist Billing Tips for 2025

• Use modifier -AI when multiple providers are involved in inpatient care.
• Only one provider may bill initial hospital care per admission.
• Time-based documentation is crucial for critical care and prolonged services.
• Verify discharge time for 99239 billing (>30 minutes).
• Support medical necessity for high-level follow-up codes like 99233.

Final Thoughts

Hospitalists handle some of the most complex billing scenarios in modern medicine. With proper documentation and up-to-date coding knowledge, your practice can reduce errors, avoid audits, and get paid what it deserves. Use this Hospitalist CPT coding guide for 2025 to keep your billing on track.

Dialysis billing is highly specialized and closely regulated—especially when managing ESRD patients and submitting monthly capitation codes (MCP). Using the correct dialysis CPT codes and modifiers in 2025 helps ensure compliance with CMS rules and secures proper reimbursement for both routine and complex services.

Monthly ESRD-Related Services (MCP)

CPT Code	Description
90951	ESRD-related services, <2 years, 4+ visits
90952	<2 years, 2–3 visits
90953	<2 years, 1 visit
90954	Age 2–11, 4+ visits
90955	Age 2–11, 2–3 visits
90956	Age 2–11, 1 visit
90957	Age 12–19, 4+ visits
90958	Age 12–19, 2–3 visits
90959	Age 12–19, 1 visit
90960	Age 20+, 4+ visits
90961	Age 20+, 2–3 visits
90962	Age 20+, 1 visit
90963	Home dialysis, <2 years
90964	Home dialysis, age 2–11
90965	Home dialysis, age 12–19
90966	Home dialysis, age 20+

Individual Dialysis Sessions

CPT Code	Description
90935	Hemodialysis, single evaluation
90937	Hemodialysis, repeated evaluations
90945	Peritoneal dialysis, one-time
90947	Peritoneal dialysis, repeated evaluations

Dialysis Training & Supervision

CPT Code	Description
90989	Dialysis training, initial
90993	Dialysis training, additional

Dialysis Modifiers

Modifier	Description
-25	Separate E/M on same day as dialysis
-26	Professional component only
-GC	Resident under supervision
-G1	ESRD patient with 4+ sessions/month
-G2	ESRD patient with 2–3 sessions/month
-G3	ESRD patient with 1 session/month
-G4	ESRD patient on home dialysis

ICD-10 Codes Commonly Paired With Dialysis

ICD-10 Code	Description
N18.6	End-stage renal disease (ESRD)
Z99.2	Dependence on renal dialysis
T86.10	Kidney transplant complication
Z94.0	Kidney transplant status
I12.9	Hypertensive CKD without heart failure
N17.9	Acute kidney failure, unspecified

Dialysis Billing Tips for 2025

• Only bill one MCP code per calendar month, based on visits and age group.
• Document oversight for home dialysis codes (90963–90966).
• Use -25 when billing E/M on the same day as dialysis service.
• Include N18.6 or another ESRD-related diagnosis on all relevant claims.

Final Thoughts

Dialysis coding is a core component of nephrology billing—and accuracy is essential. Use this 2025 dialysis CPT code and modifier guide to protect your practice from underpayments and denials while staying compliant with Medicare and commercial payers.