Summary & Overview

HCPCS G8713: Single-Pool Kt/V ≥ 1.2 (Dialysis Adequacy)

HCPCS Level II code G8713 denotes a dialysis adequacy metric — single-pool urea clearance normalized to volume (Kt/V) with a value ≥ 1.2. This code is used to document assessment of hemodialysis effectiveness in removing urea, a key indicator of treatment quality and patient safety. Nationally, consistent measurement of Kt/V supports clinical management of dialysis patients and informs quality reporting and payment programs.

Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical context for G8713, typical sites where the service is delivered, and the role this measure plays in dialysis care. The publication summarizes available benchmarks and common billing considerations, highlights where policy updates or payer coverage rules may affect use of the code, and identifies related coding and documentation practices.

This summary is intended for a national audience of billing professionals, dialysis clinicians, and policy analysts seeking concise information on coding for dialysis adequacy measurement and how it intersects with payer requirements and quality measurement.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareG8713HCPCS Level IIdialysisKt/Vurea clearancehemodialysisquality measureoutpatient dialysis

Billing Code Overview

HCPCS Level II code G8713 describes a measurement of dialysis adequacy: single-pool clearance of urea (Kt) divided by volume (V) with a Kt/V value greater than or equal to 1.2. This measure indicates the efficiency of urea removal during a hemodialysis treatment.

Service type: Dialysis adequacy measurement / Clinical laboratory or dialysis service related to hemodialysis monitoring.

Typical site of service: Outpatient dialysis center or hospital-based dialysis unit.

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 62-year-old patient with end-stage renal disease on thrice-weekly in-center hemodialysis undergoes routine monthly adequacy assessment. The dialysis clinic measures single-pool Kt/V (spkt/v) to evaluate dialysis dose; a reported value of G8713 corresponds to spkt/v greater than or equal to 1.2. The clinical workflow includes pre-dialysis weight, post-dialysis weight, ultrafiltration volume, blood flow and dialysate flow documentation, and laboratory urea values (pre- and post-dialysis). A dialysis nurse or technician records treatment parameters during the session, the dialysis facility or nephrology provider calculates the single-pool Kt/V, documents the result in the patient record, and the facility bills the measurement/quality metric indicator using G8713 when spkt/v ≥ 1.2 for the reporting period. Reporting supports quality reporting programs and payer performance metrics and is typically performed in outpatient dialysis centers or hospital-based dialysis units.

Coding Specifications

Modifier	Description	When to Use
`-26`	Professional component	Use when reporting only the physician professional component of a service related to dialysis adequacy interpretation, if applicable.
`-TC`	Technical component	Use when reporting only the technical component of a service (facility measurement or lab component) related to dialysis adequacy.
`-59`	Distinct procedural service	Use when an unrelated procedure is performed on the same date that is distinct from dialysis adequacy measurement.
`-76`	Repeat procedure by same physician	Use when a repeat measurement is performed by the same provider during the same day.
`-77`	Repeat procedure by another physician	Use when a repeat measurement is performed by a different physician the same day.
`-JW`	Drug discarded/unused portion	Not typically used for `G8713` but available if a drug wastage adjunct were billed alongside a dialysis service.
`-GN`	Service delivered under an ACO assignment	Use when the service is furnished under an Accountable Care Organization arrangement.
`-GO`	Service delivered under a Rural Health Clinic (RHC) or Federally Qualified Health Center (FQHC)	Use when applicable to the site billing environment.
`-PO`	Outpatient value modifier	Use when applicable to outpatient prospective payment adjustments (site-specific use varies).
`-QW`	CLIA waived test	Use if a waived point-of-care urea test was used for the measurement and the payer requires the modifier.

Taxonomy Code	Specialty	Notes
`2080P0800X`	Nephrology	Physicians who manage dialysis prescriptions and interpret Kt/V results.
`174H00000X`	Dialysis Technician	Staff who perform dialysis treatments and document treatment parameters used to calculate spKt/V.
`261QM0800X`	Nurse Practitioner	Advanced practice providers who manage dialysis patients and order/interpret adequacy testing.
`310400000X`	Registered Nurse	Clinical staff involved in obtaining weights, treatment data, and documentation of adequacy metrics.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N18.6`	End stage renal disease	Primary indication for maintenance hemodialysis and routine spKt/V monitoring.
`N18.5`	Chronic kidney disease, stage 5	CKD stage requiring evaluation of dialysis adequacy when dialysis is initiated or ongoing.
`Z99.2`	Dependence on renal dialysis	Identifies patients who require regular dialysis; used for quality reporting of dialysis adequacy metrics.
`I12.0`	Hypertensive chronic kidney disease with stage 5 CKD or end stage renal disease	Common comorbidity in dialysis patients; relevant to overall management and interpretation of adequacy.
`E10.22`	Type 1 diabetes mellitus with diabetic chronic kidney disease	Diabetes-related kidney disease leading to dialysis; adequacy monitoring is part of care.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`90935`	Hemodialysis procedure with single evaluation by a physician or other qualified health care professional; for patients in hospital or other facility, per dialysis administration	May be billed for the dialysis session during which adequacy (spKt/V) is measured.
`90937`	Hemodialysis procedure requiring repeated evaluations during a course of care, per dialysis session	Used when more intensive physician evaluation accompanies dialysis treatments where Kt/V monitoring is documented.
`82043`	Assay of urea nitrogen, serum	Laboratory test providing urea value used in Kt/V calculation; commonly performed pre- and post-dialysis.
`96360`	Intravenous infusion for chemotherapy, hydration, or other therapeutic/diagnostic purposes, initial 60 minutes (if applicable)`	Occasionally relevant when additional IV therapies are administered during dialysis sessions; included when clinically performed alongside adequacy measurement.
`99091`	Collection and interpretation of physiologic data digitally stored and transmitted by the patient and/or caregiver to the physician, requiring a minimum of 30 minutes of time	May apply when remote monitoring or data collection systems calculate and transmit dialysis adequacy metrics for clinician review.