Summary & Overview
HCPCS G1027: Hemodialysis Adult Patient-Months with Short-Term Catheter Use
HCPCS Level II code G1027 documents the count of adult patient-months on maintenance hemodialysis who were attributed to the same practitioner or group partner and used a catheter continuously for less than three months as of the last session in the reporting month. The metric is important for national monitoring of vascular access patterns in dialysis populations and contributes to quality assessment and performance measurement for nephrology care. Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of what the code represents, the clinical context for catheter use in maintenance hemodialysis, and the typical sites of care where this measure applies. The publication outlines common modifiers associated with claims filing, notes where input data were not provided, and identifies related administrative and reporting considerations. It also summarizes what the code measures for benchmarking and quality reporting, and flags areas where policy updates or payer-specific reporting rules may affect claim submission. Data not available in the input is clearly noted where applicable.
Billing Code Overview
HCPCS Level II code G1027 represents the number of adult patient-months in the denominator who were on maintenance hemodialysis under the care of the same practitioner or group partner as of the last hemodialysis session of the reporting month using a catheter continuously for less than three months. This measure captures catheter use duration among adult maintenance hemodialysis patients attributed to a single practitioner or group partner as of the last session in the reporting month.
-
Service type: Measurement and reporting of vascular access status for adult maintenance hemodialysis patients using a catheter continuously for less than three months
-
Typical site of service: Outpatient hemodialysis centers or dialysis clinic settings where maintenance hemodialysis is delivered
Clinical & Coding Specifications
Clinical Context
A 62-year-old male with end-stage renal disease (ESRD) on maintenance hemodialysis receives thrice-weekly dialysis at an outpatient dialysis center. The patient had a tunneled hemodialysis catheter placed two months ago as a bridge while awaiting permanent arteriovenous fistula maturation. As of the last dialysis session in the reporting month the patient continues to dialyze through the catheter and has been under the care of the same nephrology group for the reporting month. Nursing documents catheter exit site care, dialysis adequacy, and access-related complications during each session. Quality reporting staff aggregate patient-months meeting measure criteria for monthly quality metrics.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when substantial additional work is performed related to vascular access management or complex documentation beyond typical dialysis reporting requirements. |
23 | Unusual anesthesia | Use if unusual anesthesia is required during catheter manipulation or insertion-related procedures billed separately. |