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.
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.
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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. |