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The CPT® Code 90947 refers to a dialysis procedure that is distinct from hemodialysis, encompassing methods such as peritoneal dialysis, hemofiltration, and other continuous renal replacement therapies. This code is specifically utilized when the procedure necessitates repeated evaluations by a physician or another qualified healthcare professional, which may include substantial revisions to the dialysis prescription. 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 and excess fluid from the blood by passing through the peritoneal membrane into the abdominal cavity. The fluid remains in the cavity for a duration of four to six hours before being drained, along with the waste products, through the catheter. This cycle of filling and draining can occur multiple times throughout the day. Hemofiltration, on the other hand, can be performed using either an arteriovenous or venovenous approach. In the arteriovenous method, blood is drawn from the femoral artery, filtered through a membrane to remove waste and excess water, and then returned to the femoral vein, often with the addition of replacement fluids. The venovenous method involves placing a double lumen catheter in a major vein, such as the femoral, subclavian, or internal jugular vein, where a pump circulates the blood through the filtration system and back into the same vein. The distinction between CPT® Code 90945 and 90947 is critical; while 90945 is applicable for a single evaluation and management service on the same day as the dialysis procedure, 90947 is designated for instances requiring multiple evaluations during the course of the dialysis treatment.
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The procedure associated with CPT® Code 90947 is indicated for patients requiring dialysis treatments other than hemodialysis. This includes individuals who may benefit from peritoneal dialysis, hemofiltration, or other continuous renal replacement therapies. The need for repeated evaluations by a physician or qualified healthcare professional arises in situations where ongoing assessment of the patient's condition is necessary to ensure the effectiveness of the dialysis treatment and to make any required adjustments to the dialysis prescription.
The procedure for CPT® Code 90947 involves several critical steps that ensure effective dialysis treatment. Each step is designed to facilitate the removal of waste products and excess fluid from the patient's body while allowing for continuous monitoring and adjustment of the treatment plan.
Post-procedure care for patients undergoing dialysis procedures coded under CPT® 90947 includes monitoring for any complications or adverse reactions related to the dialysis treatment. Patients may experience changes in fluid balance, electrolyte levels, or signs of infection at the catheter site. Continuous evaluation by healthcare professionals is essential to ensure the patient's safety and the effectiveness of the dialysis therapy. Follow-up appointments may be scheduled to reassess the patient's condition and make any necessary modifications to the dialysis regimen. Additionally, education on self-care practices and signs of potential complications is provided to the patient and their caregivers to promote optimal recovery and management of their condition.
| Short Descr | DIALYSIS REPEATED EVAL | Medium Descr | DIALYSIS OTH/THN HEMODIALY REPEAT PHYS/QHP EVALS | Long Descr | Dialysis procedure other than hemodialysis (eg, peritoneal dialysis, hemofiltration, or other continuous renal replacement therapies) requiring repeated evaluations by a physician or other qualified health care professional, with or without substantial revision of dialysis prescription | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Code Not Recognized by OPPS when submitted on Outpatient Hospital Part B Bill Type (12x/13x) | Type of Service (TOS) | 1 - Medical Care | Berenson-Eggers TOS (BETOS) | P9A - Dialysis services (Medicare Fee Schedule) | MUE | 1 | CCS Clinical Classification | 91 - Peritoneal dialysis |
| GC | This service has been performed in part by a resident under the direction of a teaching physician | GW | Service not related to the hospice patient's terminal condition | 24 | Unrelated evaluation and management service by the same physician or other qualified health care professional during a postoperative period: the physician or other qualified health care professional may need to indicate that an evaluation and management service was performed during a postoperative period for a reason(s) unrelated to the original procedure. this circumstance may be reported by adding modifier 24 to the appropriate level of e/m service. | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 95 | Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system. | AF | Specialty physician | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CR | Catastrophe/disaster related | FS | Split (or shared) evaluation and management visit | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | Q5 | Service furnished under a reciprocal billing arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner |
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| 2014-01-01 | Changed | Code description changed. |
| 2013-01-01 | Changed | Description Changed |
| 2011-01-01 | Changed | Short description changed. |
| 2001-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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