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CMS Pub. 100-04, ch. 8, § 20.1.1

Calculation for Double Amputee Dialysis Patients

activein force · 2026-08-25 – presentas-observed

For dialysis treatments on or after January 1, 2006, we are revising the reporting

requirements for value codes A8 and A9 for double amputee dialysis patients.

Weight should be calculated based on pre-amputation weight using the following

formula: Pre-amputation weight = Actual weight x 1.15

Example: Current weight for double amputee patient = 75.5 kg.

Pre-Amputation weight = 75.5 x 1.15 = 89kg.

The results should be reported under value code A8.

Height should be reported under value code A9 as pre-amputation height. Where feasible

this measurement may be obtained from Form 2728.

History

(Rev. 1389; Issued: 12-07-07; Effective: 01-01-08; Implementation: 01-07-08)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
1cebc1d4b2600d7b47dc6bef851b1da64c92494b5615d6a2396e976b955b1525
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