Map which Chapter 8 bases apply, then show the need is daily and can be met only in a SNF (the practical-matter test). This is what a coverage reviewer looks for on a Part A day.
Observation & assessment of an unstable condition
The dialysis-dependent course carries a reasonable potential for a rapid fluid-electrolyte change, access loss, or infection; monitoring volume, the access, and the post-dialysis status requires daily nursing judgment.
Covered skilled procedure; management & evaluation
Access care and peritoneal-dialysis exchanges are skilled services under Chapter 8, and managing the complex renal fluid-electrolyte and dialysis plan is a skilled service.
