G8718 Total Kt/V ≥1.7 — HCPCS Reimbursement

HCPCS Level II code G8718 denotes a clinical quality measure: total Kt/V greater than or equal to 1.7 per week, reflecting the total urea clearance relative to patient volume. This metric is used to assess dialysis adequacy across patients receiving chronic dialysis and can influence quality reporting, clinical monitoring, and payer coverage determinations. Nationally, standardized measures of dialysis adequacy matter for patient safety, quality programs, and reimbursement frameworks.

Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of what G8718 represents, the clinical context for its use in hemodialysis and peritoneal dialysis settings, and the types of benchmarks and policy topics commonly associated with dialysis adequacy measures. The publication outlines where this code applies, typical sites of service, and the role such measures play in quality reporting and payer coverage discussions. It also indicates where input data were not provided.

This summary prepares clinicians, billing professionals, and policy stakeholders to understand the clinical meaning of the code, the payer landscape most relevant to national practice, and the analytical topics—such as benchmark comparisons, coding guidance, and policy updates—that readers can expect in the full publication.

Billing Code Overview

HCPCS Level II code G8718 represents a measurement of total Kt/V greater than or equal to 1.7 per week, where Kt/V is the total clearance of urea (Kt) divided by volume (V). This metric quantifies the adequacy of dialysis therapy by combining dialysis clearance and residual renal function to assess weekly urea removal.

Service Type: Dialysis adequacy measurement

Typical Site of Service: Hemodialysis or peritoneal dialysis clinics / outpatient dialysis centers

Data not available in the input for modifiers, associated taxonomies, ICD-10 diagnoses, related codes, and service line.

Clinical Context

A 58-year-old patient with end-stage renal disease receiving thrice-weekly in-center hemodialysis is evaluated during routine monthly adequacy assessment. The dialysis center documents delivered dialysis dose using measured dialysis session data (dialyzer urea clearance, dialysis time, and patient urea distribution volume) to calculate total weekly Kt/V. The multidisciplinary workflow includes the dialysis nurse obtaining pre- and post-dialysis BUN values, the dialysis technician recording machine parameters and treatment time, the nephrologist reviewing calculated single-pool and equilibrated Kt/V per session and aggregating these to a weekly total, and the quality manager documenting that the patient’s total weekly Kt/V is greater than or equal to 1.7 per week. This determination supports clinical adequacy reporting and quality measures and may be submitted to payors for facility performance tracking and reimbursement reporting when required.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	When only the physician interpretation or professional component of a monitoring or measurement service is billed separately from the facility.
`GT`	Via interactive audio and video telecommunications

Taxonomy Code	Specialty	Notes
`2080P0207X`	Nephrology	Physicians who direct dialysis adequacy assessment and interpret Kt/V results.
`174400000X`	Nursing — Registered Nurse	Dialysis nurses who obtain samples, record treatment parameters, and document Kt/V calculations.
`335600000X`	Dialysis Technician	Technicians who operate dialysis machines and capture session data needed for Kt/V computation.
`261Q00000X`	Clinical Laboratory	Laboratory personnel and services performing BUN/urea assays used in Kt/V calculation.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N18.6`	End stage renal disease	Primary diagnosis for patients receiving maintenance hemodialysis and for whom total weekly Kt/V is a key adequacy metric.
`N18.5`	Chronic kidney disease, stage 5	Patients approaching ESRD or on dialysis where Kt/V monitoring is performed to assess dialysis dose.
`Z99.2`	Dependence on renal dialysis	Administrative code indicating dialysis dependence; relevant when documenting ongoing adequacy monitoring.
`E86.0`	Dehydration	Clinical condition that can affect urea distribution volume (V) and thus impact Kt/V calculations.
`R79.89`	Other abnormal findings of blood chemistry	Used when abnormal urea or metabolic parameters prompt reassessment of dialysis adequacy.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`81595`	Urea nitrogen, quantitative; enzymatic, per 24 hours or spot specimen (if applicable to urea measurement)	Laboratory assay used to determine serum urea values needed for Kt/V calculation.
`82565`	Creatinine; blood, quantitative	Often performed alongside urea testing for overall metabolic assessment in dialysis patients.
`90935`	Hemodialysis procedure with single evaluation by a physician (outpatient)	Represents the dialysis treatment session during which Kt/V is measured or calculated.
`90937`	Hemodialysis procedure requiring repeated evaluation(s) by a physician	Billed when more intensive physician evaluations occur during dialysis sessions related to adequacy issues.
`99000`	Handling and/or conveyance of specimen for transfer from the office to a laboratory	Administrative service related to transporting blood samples for urea testing when separate handling applies.

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Summary & Overview

HCPCS G8718: Total Kt/V ≥ 1.7 per Week