Chronic kidney disease management
Applies to members of:
Commercial group and individual plans
Medicaid and Healthy Michigan Plan
Definition
Chronic kidney disease is the progressive loss of kidney function over time, leading eventually to kidney failure.
Medical policy
End-stage Renal Disease (ESRD) - 91526
Clinical practice guideline:
Recommendations from the Michigan Quality Improvement Consortium for screening, diagnosis and aggressive management by clinical stage.
Practice management links
CKDintercept program from the National Kidney Foundation
Clinician tools from the National Kidney Foundation
Patient education links
CKD information and treatment options for patients from Emmi®
- To use Emmi, simply enter the patient first and last name, DOB, and email address.
Kidney Smart® classes offered through Davita
Chronic kidney disease services authorizations
Prior authorization is required for many/most services. See the medical policy for details.
Educational services billing
Payable under HMO/POS, PPO, Medicare:
- G0420, Face-to-face educational services related to the care of chronic kidney disease; individual, per session, per one hour
- G0421, Face-to-face education services related to the care of chronic kidney disease; group, per session, per one hour
Coordination of care
Our Behavioral Health department has clinical staff available who specialize in helping members manage complex and chronic mental health and substance use conditions.
Drug coverage
View information for drugs covered under pharmacy and medical benefit.
Contact us
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