CMS SOM App. H, Tag V511

The patient’s comprehensive assessment must

include, but is not limited to, the following: (8) Evaluation of dialysis access type and

maintenance (for example, arteriovenous fistulas, arteriovenous grafts and peritoneal

catheters).

Interpretive Guidance §494.80(a)(8)

The efficacy of the HD patient’s vascular access and the PD patient’s peritoneal catheter

correlates with the quality (adequacy) of their dialysis treatments and is of vital importance to

their overall health status.

Each HD patient should undergo an evaluation to determine the most appropriate type and

location of vascular access, as well as the capacity of the vascular access to facilitate adequate

dialysis treatments.

Completion of this evaluation may include referrals to other facilities, such as a radiologist or

interventionist for vessel mapping or a vascular surgeon for access placement. Such referrals

may occur as part of an assessment or as part of a plan of care if the referral is intended to

address inadequate vascular access.

Evaluation of a PD patient’s peritoneal catheter would include assessment of the exit site and

tunnel for signs of infection, and of the catheter for patency and proper function.

The requirements for vascular access plan of care are at V550 and V551.