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CMS Pub. 100-04, ch. 8, § 200

Utilization of REMIS for A/B MAC (B) Claims Adjudication

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

Renal Management Information System (REMIS) determines the Medicare coverage

periods for ESRD patients and serves as the primary mechanism to store and access

information in the ESRD Program Management and Medical Information System

Database. REMIS is used by CMS and the renal community to monitor the Medicare

status, transplant activities, dialysis activities, and Medicare utilization of ESRD patients

and their Medicare provider.

The following fields are contained in the (Dialysis) auxiliary file:

• ESRD Coverage Start Date (The date on which the beneficiary is entitled to

Medicare, in some part, because of a diagnosis of End Stage Renal Disease.)

• ESRD Coverage Source Code (The source of the information that establishes

Medicare-based End-Stage Renal Disease Coverage; A= Part A and Dialysis

Training, B= Part A and Dialyzing (No 3 month wait), C= Part A and 3 months

after Dialysis, D= Part A and Functioning Transplant, E= Part A and Month of

Pre-Transplant Stay, F= Part A and ESRD (Verified Source), Blank= No ESRD

Involvement.)

• ESRD Coverage Termination Date (The date on which the beneficiary is no

longer entitled to Medicare under ESRD Provisions.)

• ESRD Coverage Termination Reason (A code that indicates the reason

Medicare-based End-Stage Renal Disease Coverage was terminated; codes: A=

Month of transplant plus 36 months, B=Last month of chronic dialysis, C= Part A

termination, D=Death, E=ESRD ended: other verified source.)

• ESRD Dialysis Start Date (A date that indicates when ESRD dialysis started.)

• ESRD Dialysis Stop Date (A date that indicates when ESRD dialysis ended.)

• ESRD Transplant Start Date (A date that indicates when a kidney transplant

operation occurred.)

• ESRD Transplant Stop Date (A date that indicates when a kidney transplant

failed.)

The above data elements are in CWF and stored in the dialysis auxiliary file, which can

be used to identify a beneficiary’s ESRD eligibility. This data source will assist carriers

in reviewing overpayment determination and accurately processing claims.

History

(Rev. 82, 02-06-04)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
262a6436f53a616488a0e92c3d7eecc034b4770dcede0df467231534746e2ba5
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