CPT® Code 90947

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

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.