CMS Pub. 100-02, ch. 15, § 310.4

Medicare Part B covers KDE services, provided by a qualified person, which provide

comprehensive information regarding:

A. The management of comorbidities, including delaying the need for dialysis, which

includes, but is not limited to, the following topics:

• Prevention and treatment of cardiovascular disease,

• Prevention and treatment of diabetes,

• Hypertension management,

• Anemia management,

• Bone disease and disorders of calcium and phosphorus metabolism management,

• Symptomatic neuropathy management, and

• Impairments in functioning and well-being.

B. Prevention of uremic complications, which includes, but is not limited to, the

following topics:

• Information on how the kidneys work and what happens when the kidneys fail,

• Understanding if remaining kidney function can be protected, preventing disease

progression, and realistic chances of survival,

• Diet and fluid restrictions, and

• Medication review, including how each medication works, possible side effects

and minimization of side effects, the importance of compliance, and informed

decision making if the patient decides not to take a specific drug.

C. Therapeutic options, treatment modalities and settings, advantages and

disadvantages of each treatment option, and how the treatments replace the

kidney, including, but not limited to, the following topics:

• Hemodialysis, both at home and in-facility;

• Peritoneal dialysis (PD), including intermittent PD, continuous ambulatory PD,

and continuous cycling PD, both at home and in-facility;

• All dialysis access options for hemodialysis and peritoneal dialysis; and

• Transplantation.

D. Opportunities for beneficiaries to actively participate in the choice of therapy and

be tailored to meet the needs of the individual beneficiary involved, which

includes, but is not limited to, the following topics:

• Physical symptoms,

• Impact on family and social life,

• Exercise,

• The right to refuse treatment,

• Impact on work and finances,

• The meaning of test results, and

• Psychological impact.