US · guidance
CMS Pub. 100-04, ch. 32, § 20.2
Healthcare Common Procedure Coding System (HCPCS) Procedure Codes and
Applicable Diagnosis Codes
(Rev. 2998, Issued: 07-25-14, Effective: Upon implementation of ICD-10; 01-01-12 - ASC X12, Implementation: 08-25-2014 - ASC X12; Upon Implementation of ICD-10)
Effective for services performed on and after January 1, 2010, the following new HCPCS codes have been created for
KDE services when provided to patients with stage IV CKD.
• G0420: Face-to-face educational services related to the care of chronic kidney disease; individual, per session,
per one hour
• G0421: Face-to-face educational services related to the care of chronic kidney disease; group, per session, per
one hour
When billing for KDE services the applicable ICD diagnosis code shall be used:
• If ICD-9-CM is applicable, ICD-9-CM - 585.4 (chronic kidney disease, Stage IV (severe)), or
• If ICD-9-CM is applicable, ICD-10-CM – N18.4 (Chronic Kidney Disease, stage 4.
NOTE: Claims with HCPCS codes G0420 or G0421 and ICD-9 code 585.4, if applicable, or, if ICD -10 is
applicable, ICD-10 code N18.4 that are billed for KDE services are not allowed on a professional and institutional
claim on the same service date.
History
(Rev. 2998, Issued: 07-25-14, Effective: Upon implementation of ICD-10; 01-01-12 - ASC X12, Implementation: 08-25-2014 - ASC X12; Upon Implementation of ICD-10)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
c8fb42e334a767664d017fba9006ed3c4cb95fbceec1d986130e2ed2003b8658
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