DI 45001.000 ODO Processing of Initial End-Stage Renal Disease (ESRD) Medicare Cases

Subchapter Table of Contents
Section Latest
Transmittal
DI 45001.001End-Stage Renal Disease (ESRD) Entitlement Provisions 
DI 45001.005Processing ESRD ClaimsTN 2 07-04
DI 45001.010Non-Medical Review of Non-DOFA ESRD Claims 
DI 45001.015Medical Review of Non-DOFA ESRD Claims 
DI 45001.020Processing ESRD Claims of Railroad Retirement Beneficiaries 
DI 45001.025Completion of the SSA-892-U3 
DI 45001.030Completion of the Automated 101 (A101) 
DI 45001.040Multiple ESRD Entitlement Periods 
DI 45001.045Establishing a Temporary HI Record 
DI 45001.055Report of Transplant or Cessation of Dialysis After Entitlement 
DI 45001.060Equitable Relief in Initial ESRD Cases 
DI 45001.065Processing ESRD Medicare Disallowances 
DI 45001.070State Buy-In Agreement 
DI 45001.075ESRD Notices 
Exhibits—Notices and Forms
DI 45001.076ESRD Medicare Disallowance 
DI 45001.077R-HI/R-SMI Award Based on Kidney Transplant (Temporary Notice)BASIC 03-86
DI 45001.078R-HI/R-SMI Award Based on Kidney Dialysis—Training Approved (Temporary Notice)BASIC 03-86
DI 45001.079R-HI/R-SMI Award Based on Kidney Dialysis—No Participation in Self-Dialysis Training (Temporary Notice)BASIC 03-86
DI 45001.080R-HI/R-SMI Award Based on Kidney Dialysis—Self-Dialysis Training Questionable (Temporary Notice)BASIC 03-86
DI 45001.081R-HI/R-SMI Award Based on Transplant or Dialysis, Entitlement Dates Are the Same or Later Than D-HI/D-SMI Coverage (Conversion Notice)BASIC 03-86
DI 45001.082R-HI/R-SMI Award Based on Transplant or Dialysis, Entitlement Dates Are the Same or Later Than Age 65 HI/SMI Coverage (Conversion Notice)BASIC 03-86
DI 45001.083R-HI/R-SMI Award Based on Transplant to Premium HI/SMI Beneficiary, Entitlement Dates Are The Same or Later Than Premium HI/SMI Coverage (Conversion Notice)BASIC 03-86
DI 45001.084R-HI/R-SMI Award Based on Dialysis to Premium HI/SMI Beneficiary, Entitlement Dates Are The Same or Later Than Premium HI/SMI Coverage (Conversion Notice)BASIC 03-86
DI 45001.085R-HI/R-SMI Award Based on Transplant, Age 65 SMI Beneficiary Did Not Have HI (Conversion Notice)BASIC 03-86
DI 45001.086R-HI/R-SMI Award Based on Dialysis, Age 65 SMI Beneficiary Did Not Have HI (Conversion Notice)BASIC 03-86
DI 45001.087Subsequent Determination of Deferred Decision, Approval of Earlier R-HI/ R-SMI Entitlement Based on Self-Dialysis TrainingBASIC 03-86
DI 45001.088Subsequent Determination of Deferred Decision, Denial of Earlier R-HI/ R-SMI Entitlement Based on Self-Dialysis TrainingBASIC 03-86
DI 45001.089Acknowledgement of Report of Kidney TransplantBASIC 03-86
DI 45001.090Acknowledgement of Report of Cessation of a Regular Course of DialysisBASIC 03-86
DI 45001.091Dialysis Cessation Pre-termination Notice of R-HI/R-SMI, and Request for Completion of Form CMS-2728-U3, End Stage Renal Disease Medical Evidence Report Medicare Entitlement and/or Patient RegistrationBASIC 03-86
DI 45001.092Transplant Pre-termination Notice of R-HI/R-SMI, and Request for Completion of Form CMS-2728-U3, End Stage Renal Disease Medical Evidence Report Medicare Entitlement and/or Patient RegistrationBASIC 03-86
DI 45001.093R-HI/R-SMI Coverage Continuance—Dialysis Resumed After TransplantBASIC 03-86
DI 45001.094R-HI Entitlement, R-SMI Refused (Temporary Notice)BASIC 03-86
DI 45001.095Revised Determination, Earlier Medicare Entitlement Based on TransplantBASIC 03-86
DI 45001.096R-HI/R-SMI Entitlement Based on Transplant, Closed PeriodBASIC 03-86
DI 45001.097R-HI/R-SMI Entitlement Based on Dialysis, Closed PeriodBASIC 03-86
DI 45001.098Final Notice of Medicare Termination Due to ESRD Cessation (Dialysis Ended)BASIC 03-86
DI 45001.099Final Notice of Medicare Termination Due to ESRD Cessation (Transplant)BASIC 03-86
DI 45001.100Notification of Equitable Relief—ESRD Termination (Dialysis), DOTH is Earlier Than DOTS—Beneficiary Not Notified TimelyBASIC 03-86
DI 45001.101Notification of Equitable Relief—ESRD Termination (Transplant), DOTH is Earlier Than DOTS—Beneficiary Not Notified TimelyBASIC 03-86
DI 45001.102R-HI/R-SMI Award When RRB Jurisdiction for Medicare is InvolvedBASIC 03-86
DI 45001.103Final Notice of Medicare Termination (Due to ESRD and Dialysis Cessations) When RRB Jurisdiction is InvolvedBASIC 03-86
DI 45001.104Final Notice of Medicare Termination (Due to ESRD Cessation—Transplant) When RRB Jurisdiction is InvolvedBASIC 03-86
DI 45001.105R-HI/R-SMI Award When RRB Jurisdiction Involved—LAF Code “E” Cases 
DI 45001.106Form, HCFA-8063 - Internal Temporary HI Record 
DI 45001.107Signature File Card for Completion of Form HCFA-8063BASIC 03-86
DI 45001.108CRD (ESRD) Kidney Transplant Beneficiaries ListingBASIC 03-86
DI 45001.109HIB-SMIB Data Enrollment Card Coding Sheet 
DI 45001.110Renal Provider List 
DI 45001.111Form SSA-892-U3—End Stage Renal Disease (ESRD) Medicare Determination 
DI 45001.200Federal Employment Involved in the Insured Status of ESRD Medicare Claimants 
DI 45001.205FO Responsibilities for ESRD Claims 
DI 45001.210ODO Earnings Reviewer Responsibilities 
DI 45001.313Case Processing — Initial Awards (No Record of Beneficiary on MBR) or Claimant Had Medicare Entitlement Which Has Ceased on Own SSNTN 1 07-04
DI 45001.324Processing ESRD Medicare Claims With Railroad Retirement Board InvolvementTN 1 07-04
DI 45001.326Processing ESRD Claims Involving Insured Status Based on Government EmploymentTN 1 07-04
DI 45001.330Equitable Relief in Initial ESRD CasesTN 1 07-04
DI 45001.340ES