CPT® Code 90945

Dialysis procedure other than hemodialysis (eg, peritoneal dialysis, hemofiltration, or other continuous renal replacement therapies), with single evaluation by a physician or other qualified health care professional

The CPT® Code 90945 refers to a dialysis procedure that is not classified as hemodialysis, encompassing methods such as peritoneal dialysis, hemofiltration, and other continuous renal replacement therapies. These procedures are designed to filter blood continuously, providing an alternative to traditional hemodialysis. In peritoneal dialysis, a nurse or technician administers dialysis fluid through a catheter that has been previously placed in the abdomen. This fluid, which contains dextrose, facilitates the removal of waste products and excess fluid from the blood by utilizing the peritoneal membrane, allowing these substances to transfer into the abdominal cavity. The dialysis solution is retained in the abdomen for a duration of four to six hours before being drained, along with the waste, through the catheter. This cycle of filling and draining can be repeated multiple times throughout the day. Hemofiltration, another method included under this code, can be performed using either an arteriovenous or venovenous approach. In the arteriovenous method, the femoral artery is accessed, and blood is propelled through a filter into the femoral vein, where water and soluble waste are removed via a permeable membrane. The purified blood is then returned to the body, supplemented with a balanced solution of water and electrolytes. The venovenous approach is similar, involving the placement of a double lumen catheter in a major vein, such as the femoral, subclavian, or internal jugular vein, with a pump facilitating the movement of blood through the dialysis circuit and back into the same vein. CPT® Code 90945 is specifically utilized when a single evaluation and management service is conducted on the same day as the dialysis procedure. In contrast, if multiple evaluations are necessary during the course of the dialysis treatment, CPT® Code 90947 should be employed. This distinction is crucial for accurate coding and billing practices in the context of renal replacement therapies.