Version 2.77


Form CMS-2728-U3 - ESRD Medical Evidence Report, Medicare Entitlement, (Patient Registration) is completed on each incident ESRD patient or each patient re-entering the Medicare program. Dialysis and transplant facilities must submit this form to the Networks within 45 days from the date a patient is diagnosed with ESRD and either has a transplant or begins a regular course of dialysis. This form is also mandatory if a patient loses Medicare coverage and re-applying for benefits. Source: Regenstrief LOINC, Medicare ESRD Network Organizations Manual

Basic Part Properties

Part Display Name
End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
Part Type
Component (Describes the core component or analyte measured)
Created On
Construct for LOINC Short Name
ESRD CMS Form 2728

LOINC Terminology Service (API) using HL7® FHIR® Get Info

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Language Variants Get Info

Tag Language Translation
zh-CN Chinese (China) 终末期肾脏疾病医学证据报告, 医疗保险权利和或患者注册 - OMB CMS 表单 2728
Synonyms: 终末期肾脏疾病医学证据报告, 医疗保险权利和或患者(病人)注册(登记) - OMB CMS 表单 2728;ESRD 医学证据报告医疗保险权利 - OMB CMS 表单 2728;终末期肾脏疾病医学证据报告医疗保险权利 - OMB CMS 表单 2728;终末期肾脏疾病医学证明报告医疗保险资格 - OMB CMS 表单 2728;终末期肾脏疾病医学证据报告医疗保险授权 - OMB CMS 表单 2728;Centers for Medicare & Medicaid Services;Centers fo
ru-RU Russian (Russian Federation) ESRD медицинское доказательство отчёт medicare право - OMB CMS форма 2728