HCPCS Level II code G0491 identifies a dialysis procedure performed at a Medicare-certified End-Stage Renal Disease (ESRD) facility for patients with acute kidney injury (AKI) who do not have chronic ESRD. This code matters nationally because it designates services delivered in specialized dialysis centers to a population distinct from chronic dialysis patients, affecting coverage rules, facility workflows, and payer policies across public and commercial payers. Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will learn the clinical and billing context of G0491, including how the service differs from chronic ESRD dialysis, the typical site of service, and the national payers relevant to coverage. The publication summarizes benchmark considerations, common payer practices, and recent policy or coding clarifications affecting in-center dialysis for AKI without ESRD. It also provides practical reference points for coding teams and revenue cycle staff to align documentation and billing with payer expectations. Data not available in the input is clearly indicated where applicable.