Medicare Risk Adjustment Tip: ESRD and Dialysis Status

End-stage renal disease (ESRD) is a medical condition in which a person's kidneys stop working permanently, requiring a regular course of dialysis or kidney transplant for a long period of time to sustain life. Beneficiaries may be entitled to Medicare based on ESRD. Benefits based on ESRD are for all covered services and not just services related to kidney failure conditions. Once a patient is diagnosed with end-stage kidney disease and has been accepted and documented by the health plan and CMS, the patient's MRA score is calculated differently.


 

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