Nephrology EHR and AI Medical Billing Software

Nephrology follows kidney function over years and coordinates with dialysis centers and transplant teams. XEHR keeps the trend, the plan and the billing in one record.

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Chart · Office visit

Lastname, Firstname M. Sample patient · DOB 01/01/1980 · Commercial

Eligible

BP128/82

HR72

BMI26.4

Temp98.6

Progress noteAI Scribe draft

Kidney function review; no new symptoms.

N18.4 Chronic kidney disease, stage 4

ReviewSign note

Diagnosis carried to the claimN18.4

THE HARD PARTS

What makes nephrology billing hard

Monthly services with strict rules

Dialysis-related physician services are billed monthly, with visit counts that decide the payment level.

Stage changes that change care

As kidney function declines, the stage drives referrals, education and planning. Missing a change delays care.

Care shared with other teams

Dialysis units, transplant centers and primary care all need the same current information.

WHERE THE WORK HAPPENS

How nephrology care is delivered and billed

Nephrology covers the office, the hospital and the dialysis unit. Chronic kidney disease visits are billed on the professional claim; dialysis patients are managed under a monthly service that depends on the patient’s age and the number of face-to-face visits in the month. Hospital consults for acute kidney injury and transplant follow-up add to the mix, so one nephrologist bills in several settings every month.

What payers check on nephrology claims

The monthly dialysis service is billed once per month and its level depends on the patient’s age and the number of face-to-face visits.
Hypertension and chronic kidney disease together are coded with the combination code, plus a code for the stage.
Diabetic kidney disease is coded with the diabetes combination code and the stage of chronic kidney disease.
Kidney disease education under Medicare is limited to patients in stage 4 and to a set number of sessions.
Hospital consults for acute kidney injury are billed with the hospital place of service and the level supported by the note.

Common nephrology diagnoses ICD-10-CM

N18.4	Chronic kidney disease, stage 4 (severe)
N18.6	End stage renal disease
I12.9	Hypertensive chronic kidney disease with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
E11.22	Type 2 diabetes mellitus with diabetic chronic kidney disease
N17.9	Acute kidney failure, unspecified
Z99.2	Dependence on renal dialysis

Examples only. The provider chooses the code that matches the documented diagnosis, and XEHR checks it against the note and the payer's rules before the claim goes out.

A VISIT ON XEHR

A nephrology visit, start to payment

1
Track the stage

Kidney function results are trended in the chart, and the stage of chronic kidney disease is kept current on the problem list.
2
Count the dialysis visits

For dialysis patients, each face-to-face visit in the month is recorded so the monthly service is billed at the right level.
3
Prepare for what is next

Access planning, transplant referral and education are documented as the disease progresses.
4
Bill each setting

Office, hospital and dialysis unit services are billed with their own place of service, from one record.

How XEHR helps

From the nephrology visit to the payment

Visit counts kept for youVisits are recorded against the month, so the claim reflects what was actually provided.
Lab trends in the chartKidney function and related results are kept over time for review at every visit.
Records you can shareRecords exchange with other providers using industry standards.
AI that waits for youThe AI drafts notes and prepares claims; your providers sign and your billers approve.

Claim · CMS-1500

Sample claimLastname, Firstname M. · DOS 03/04/2026

Scrub passed

Scrubbed
Submitted
Accepted
Paid

Service	Dx	Units	Charge
Office visit	E11.9	1	145.00
A1c test	E11.9	1	28.00
Total			173.00

ERA postedPayment applied, no re-keying

Agentic AI for nephrology

AI medical billing for nephrology practices

XEHR is an agentic EHR: AI agents do the administrative work around every nephrology visit, and your team approves what matters. How agentic AI works

Before the claim leaves

The claim-check agent looks for

The monthly dialysis service is billed once per month and its level depends on the patient’s age and the number of face-to-face visits.
Hypertension and chronic kidney disease together are coded with the combination code, plus a code for the stage.
Diabetic kidney disease is coded with the diabetes combination code and the stage of chronic kidney disease.
Kidney disease education under Medicare is limited to patients in stage 4 and to a set number of sessions.

Around the visit

Agents run on their own

Coverage checked before each nephrology visit
The visit note drafted for the provider to sign
Insurance payments matched and posted
Open claims tracked, denials read and appeals drafted

People decide

Your team stays in charge

Providers sign every note
Billers approve every claim and appeal
Staff submit prior authorizations
Any check can be overridden, with a reason

BUYER'S GUIDE

Questions to ask before you choose a nephrology EHR

Ask every vendor, including us. The answers show whether a system was built for nephrology work or only adapted to it.

Ask us on a demo

How does the system count face-to-face dialysis visits to bill the monthly service at the right level?
Are kidney function results trended and the disease stage kept current?
Does the claim use the combination codes for hypertensive and diabetic kidney disease?
Can office, hospital and dialysis unit work be billed from one record?
Is kidney disease education tracked against Medicare’s session limits?

QUESTIONS

Nephrology practices ask us

Does XEHR support monthly dialysis-related billing?

Yes. Visits are tracked within the month and billed when the month closes.

Can XEHR share records with dialysis centers?

Yes, using standard record exchange. We confirm the connection with your partners during onboarding.

Does XEHR handle the monthly dialysis service?

Yes. Face-to-face visits are counted through the month so the service is billed once, at the level the visits support.

Can XEHR show kidney function trends?

Yes. Results are trended in the chart and the disease stage stays current on the problem list.

Can XEHR support transplant referral and follow-up?

Yes. Referrals, evaluation items and post-transplant labs are tracked in the patient record.

Does XEHR handle hospital consults for acute kidney injury?

Yes. Consults are billed with the hospital place of service.

How much does XEHR cost for a nephrology practice?

Pricing is published: $189 per provider per month for the Clinical plan, $449 per provider per month for the Practice Suite with billing, or 2.5% of collections for RCM as a Service. Month-to-month, with a BAA on every plan. See pricing.

How long does it take a nephrology practice to go live?

Small practices are usually live in 2 to 4 weeks, including setup, data migration and training. We agree the plan with you before you sign.

Related specialties

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See XEHR set up for nephrology

A 30-minute walkthrough on a live test environment, with your specialty's templates and billing.

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