| Section |
|
Latest
Transmittal |
| DI 45001.001 |
End-Stage Renal Disease (ESRD) Entitlement Provisions |
TN 7 01-23 |
| DI 45001.005 |
Processing ESRD Claims |
TN 6 09-22 |
| DI 45001.010 |
Non-Medical Review of Non-DOFA ESRD Claims |
|
| DI 45001.015 |
Medical Review of Non-DOFA ESRD Claims |
TN 4 10-21 |
| DI 45001.020 |
Processing ESRD Claims of Railroad Retirement Beneficiaries |
|
| DI 45001.025 |
Completion of the SSA-892-U3 |
|
| DI 45001.030 |
Completion of the Automated 101 (A101) |
|
| DI 45001.040 |
Multiple ESRD Entitlement Periods |
|
| DI 45001.045 |
Establishing a Temporary HI Record |
|
| DI 45001.055 |
Report of Transplant or Cessation of Dialysis After Entitlement |
|
| DI 45001.060 |
Equitable Relief in Initial ESRD Cases |
|
| DI 45001.065 |
Processing ESRD Medicare Disallowances |
|
| DI 45001.070 |
State Buy-In Agreement |
|
| DI 45001.075 |
ESRD Notices |
|
| Exhibits—Notices and Forms
|
| DI 45001.076 |
ESRD Medicare Disallowance |
|
| DI 45001.077 |
R-HI/R-SMI Award Based on Kidney Transplant (Temporary Notice) |
TN BASIC 03-86 |
| DI 45001.078 |
R-HI/R-SMI Award Based on Kidney Dialysis—Training Approved (Temporary Notice) |
TN BASIC 03-86 |
| DI 45001.079 |
R-HI/R-SMI Award Based on Kidney Dialysis—No Participation in Self-Dialysis Training
(Temporary Notice)
|
TN BASIC 03-86 |
| DI 45001.080 |
R-HI/R-SMI Award Based on Kidney Dialysis—Self-Dialysis Training Questionable (Temporary
Notice)
|
TN BASIC 03-86 |
| DI 45001.081 |
R-HI/R-SMI Award Based on Transplant or Dialysis, Entitlement Dates Are the Same or
Later Than D-HI/D-SMI Coverage (Conversion Notice)
|
TN BASIC 03-86 |
| DI 45001.082 |
R-HI/R-SMI Award Based on Transplant or Dialysis, Entitlement Dates Are the Same or
Later Than Age 65 HI/SMI Coverage (Conversion Notice)
|
TN BASIC 03-86 |
| DI 45001.083 |
R-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)
|
TN BASIC 03-86 |
| DI 45001.084 |
R-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)
|
TN BASIC 03-86 |
| DI 45001.085 |
R-HI/R-SMI Award Based on Transplant, Age 65 SMI Beneficiary Did Not Have HI (Conversion
Notice)
|
TN BASIC 03-86 |
| DI 45001.086 |
R-HI/R-SMI Award Based on Dialysis, Age 65 SMI Beneficiary Did Not Have HI (Conversion
Notice)
|
TN BASIC 03-86 |
| DI 45001.087 |
Subsequent Determination of Deferred Decision, Approval of Earlier R-HI/ R-SMI Entitlement
Based on Self-Dialysis Training
|
TN BASIC 03-86 |
| DI 45001.088 |
Subsequent Determination of Deferred Decision, Denial of Earlier R-HI/ R-SMI Entitlement
Based on Self-Dialysis Training
|
TN BASIC 03-86 |
| DI 45001.089 |
Acknowledgement of Report of Kidney Transplant |
TN BASIC 03-86 |
| DI 45001.090 |
Acknowledgement of Report of Cessation of a Regular Course of Dialysis |
TN BASIC 03-86 |
| DI 45001.091 |
Dialysis 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 Registration
|
TN BASIC 03-86 |
| DI 45001.092 |
Transplant 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 Registration
|
TN BASIC 03-86 |
| DI 45001.093 |
R-HI/R-SMI Coverage Continuance—Dialysis Resumed After Transplant |
TN BASIC 03-86 |
| DI 45001.094 |
R-HI Entitlement, R-SMI Refused (Temporary Notice) |
TN BASIC 03-86 |
| DI 45001.095 |
Revised Determination, Earlier Medicare Entitlement Based on Transplant |
TN BASIC 03-86 |
| DI 45001.096 |
R-HI/R-SMI Entitlement Based on Transplant, Closed Period |
TN BASIC 03-86 |
| DI 45001.097 |
R-HI/R-SMI Entitlement Based on Dialysis, Closed Period |
TN BASIC 03-86 |
| DI 45001.098 |
Final Notice of Medicare Termination Due to ESRD Cessation (Dialysis Ended) |
TN BASIC 03-86 |
| DI 45001.099 |
Final Notice of Medicare Termination Due to ESRD Cessation (Transplant) |
TN BASIC 03-86 |
| DI 45001.100 |
Notification of Equitable Relief—ESRD Termination (Dialysis), DOTH is Earlier Than
DOTS—Beneficiary Not Notified Timely
|
TN BASIC 03-86 |
| DI 45001.101 |
Notification of Equitable Relief—ESRD Termination (Transplant), DOTH is Earlier Than
DOTS—Beneficiary Not Notified Timely
|
TN BASIC 03-86 |
| DI 45001.102 |
R-HI/R-SMI Award When RRB Jurisdiction for Medicare is Involved |
TN BASIC 03-86 |
| DI 45001.103 |
Final Notice of Medicare Termination (Due to ESRD and Dialysis Cessations) When RRB
Jurisdiction is Involved
|
TN BASIC 03-86 |
| DI 45001.104 |
Final Notice of Medicare Termination (Due to ESRD Cessation—Transplant) When RRB Jurisdiction
is Involved
|
TN BASIC 03-86 |
| DI 45001.105 |
R-HI/R-SMI Award When RRB Jurisdiction Involved—LAF Code “E” Cases |
|
| DI 45001.106 |
Form, HCFA-8063 - Internal Temporary HI Record |
|
| DI 45001.107 |
Signature File Card for Completion of Form HCFA-8063 |
TN BASIC 03-86 |
| DI 45001.108 |
CRD (ESRD) Kidney Transplant Beneficiaries Listing |
TN BASIC 03-86 |
| DI 45001.109 |
HIB-SMIB Data Enrollment Card Coding Sheet |
|
| DI 45001.110 |
Renal Provider List |
|
| DI 45001.111 |
Form SSA-892-U3—End Stage Renal Disease (ESRD) Medicare Determination |
|
| DI 45001.200 |
Federal Employment Involved in the Insured Status of ESRD Medicare Claimants |
|
| DI 45001.205 |
FO Responsibilities for ESRD Claims |
|
| DI 45001.210 |
ODO Earnings Reviewer Responsibilities |
|
| DI 45001.313 |
Case Processing — Initial Awards (No Record of Beneficiary on MBR) or Claimant Had
Medicare Entitlement Which Has Ceased on Own SSN
|
TN 1 07-04 |
| DI 45001.324 |
Processing ESRD Medicare Claims With Railroad Retirement Board Involvement |
TN 1 07-04 |
| DI 45001.326 |
Processing ESRD Claims Involving Insured Status Based on Government Employment |
TN 1 07-04 |
| DI 45001.330 |
Equitable Relief in Initial ESRD Cases |
TN 1 07-04 |
| DI 45001.340 |
ESRD Medicare Disallowance |
TN 1 07-04 |
| DI 45001.341 |
Notice — R-HI/R-SMI Award Based on Transplant or Dialysis, Entitlement Dates are the
Same or Later Than D-HI/D-SMI Coverage (Conversion Notice)
|
TN 1 07-04 |
| DI 45001.342 |
Notice — R-HI/R-SMI Award Based on Transplant or Dialysis, Entitlement Dates are the
Same or Later Than Age 65 HI/SMI Coverage (Conversion Notice)
|
TN 1 07-04 |
| DI 45001.343 |
Notice — R-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)
|
TN 1 07-04 |
| DI 45001.344 |
Notice — R-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)
|
TN 1 07-04 |
| DI 45001.345 |
Notice — R-HI/R-SMI Award Based on Transplant, Age 65 SMI Beneficiary Did Not Have
HI (Conversion Notice)
|
TN 1 07-04 |
| DI 45001.346 |
Notice — R-HI/R-SMI Award Based on Dialysis, Age 65 SMI Beneficiary Did Not Have HI
(Conversion Notice)
|
TN 1 07-04 |
| DI 45001.347 |
Notice — R-HI/R-SMI Award When RRB Jurisdiction for Medicare is Involved: |
TN 1 07-04 |
| DI 45001.348 |
Notice — R-HI/R-SMI Award When RRB Jurisdiction Involved — LAF Code “E” Cases |
TN 1 07-04 |
| DI 45001.355 |
ESRD Paragraphs |
TN 1 07-04 |
| DI 45001.400 |
Processing Center (PC) 7 Instructions for Medicare Part B Immunosuppressive Drugs
Coverage (Part B-ID)
|
TN 8 01-23 |