CPT® Code 90967

1. Indications

The indications for the use of CPT® Code 90967 include the following:

• End-stage renal disease (ESRD) - This code is specifically utilized for patients diagnosed with ESRD who require dialysis services.
• Patients younger than 2 years of age - The services are tailored for a pediatric population, addressing the unique medical needs of infants and toddlers.
• Less than a full month of service - This code applies when the dialysis services are provided for a duration that is less than a complete month, which may occur due to various clinical circumstances.
• Outpatient setting - The services are delivered in an outpatient environment, allowing for daily management and oversight of the patient's condition.

2. Procedure

The procedural steps associated with CPT® Code 90967 are as follows:

• Establishment of the dialyzing cycle - The physician initiates the process by determining the appropriate dialyzing cycle tailored to the patient's specific needs, ensuring that the dialysis treatment is effective and safe.
• Outpatient evaluation and management - The physician conducts thorough evaluations and management services related to the dialysis, which includes assessing the patient's overall health and any complications arising from ESRD.
• Monitoring during dialysis - During the dialysis sessions, the physician provides oversight and management, ensuring that the treatment is proceeding as planned and making real-time adjustments as necessary.
• Routine patient examinations - The physician performs regular examinations to identify any existing or potential medical problems, ensuring proactive management of the patient's health.
• Adjustment of dialysis prescription - Based on ongoing assessments, the physician may modify the dialysis prescription to better meet the patient's needs, optimizing treatment outcomes.
• Monitoring of weight and dietary recommendations - The physician keeps track of the patient's weight and provides dietary guidance, including fluid intake recommendations, to support the patient's health and well-being.
• Review of laboratory data - Regular analysis of laboratory results is conducted to monitor the patient's response to treatment and to make necessary adjustments to medications and nutritional supplements.
• Coordination of comprehensive care - The physician coordinates care that may involve social services, nutritional support, and planning for kidney transplantation, ensuring a holistic approach to the patient's treatment.
• Interventions for growth and development - For younger patients, the physician initiates interventions to address any delays in growth or development, which may include the administration of growth hormones.
• Counseling and support for caregivers - The physician provides counseling to parents and caregivers, addressing their questions and concerns while ensuring they are informed about the patient's care plan.

3. Post-Procedure

Post-procedure care for patients receiving services under CPT® Code 90967 includes ongoing monitoring and evaluation of the patient's health status. The physician continues to assess the effectiveness of the dialysis treatment and makes necessary adjustments to the care plan. Regular follow-up appointments are essential to ensure that the patient is responding well to the treatment and to address any new symptoms or complications that may arise. Additionally, the physician remains involved in coordinating care with other specialists and services, ensuring that the patient's comprehensive needs are met. Parents and caregivers are encouraged to maintain open communication with the physician regarding any concerns or changes in the patient's condition, facilitating timely interventions as needed.