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2025 CPT code 90945

Dialysis procedure (excluding hemodialysis), with a single physician evaluation.

Follow CPT guidelines for dialysis services and procedures and appropriate modifier use (e.g., modifier 25 for separate E&M services). Consult payer-specific guidelines for additional requirements.

Modifier 25 may be appended to code 90945 when a separate, significant, separately identifiable E&M service is provided on the same day as the dialysis procedure. Other modifiers may be applicable depending on the specific circumstances.

Medical necessity for 90945 is established by the patient's diagnosis of ESRD or acute kidney injury requiring dialysis, and the clinical indication for the chosen dialysis modality.Documentation must demonstrate the need for the procedure and the physician's involvement in patient assessment and management.

The physician is responsible for evaluating the patient's suitability for dialysis, selecting the appropriate dialysis modality, performing the procedure, and monitoring the patient's response.This may involve pre-procedure examination, prescription and administration of dialysis, and post-procedure assessment.

IMPORTANT:For percutaneous insertion of intraperitoneal tunneled catheter, use 49418. For open insertion of tunneled intraperitoneal catheter, use 49421. For prolonged attendance by a physician or other qualified health care professional, use 99360. For repeated evaluations during a procedure, use 90947. For home infusion of peritoneal dialysis, use 99601, 99602.For therapeutic apheresis procedures, see codes 36511-36516. For therapeutic ultrafiltration, use 0692T.

In simple words: This code covers a type of dialysis treatment (not the common kind, hemodialysis) like cleaning your blood using your belly or a special filter.The doctor checks on you before starting this treatment.

This CPT code, 90945, represents a dialysis procedure other than hemodialysis, such as peritoneal dialysis, hemofiltration, or continuous renal replacement therapy (CRRT).It includes a single physician evaluation performed on the day of the procedure.The procedure may involve the introduction of dialysate into the peritoneal cavity (peritoneal dialysis), filtration of blood through a membrane (hemofiltration), or other continuous methods of removing waste products and excess fluid from the blood.The evaluation assesses the patient's overall condition, renal function, and suitability for the selected dialysis modality.Note that repeated evaluations during a single procedure are coded using CPT code 90947.

Example 1: A patient with end-stage renal disease (ESRD) undergoes peritoneal dialysis. The physician evaluates the patient, inserts the catheter (if necessary), and initiates the peritoneal dialysis session. This single evaluation is coded with 90945., A critically ill patient in the ICU requires continuous renal replacement therapy (CRRT). The physician evaluates the patient, initiates the CRRT, and monitors the patient throughout the procedure, with no additional evaluations necessary.Code 90945 is used., A patient with ESRD presents for hemofiltration. The physician performs a pre-procedure evaluation.The hemofiltration is performed, and no additional evaluations are needed. 90945 is reported.

Documentation should include the patient's history, physical examination findings, the type of dialysis performed (peritoneal dialysis, hemofiltration, CRRT), the duration of the procedure, the amount of fluid removed or infused, electrolyte levels before and after the procedure, and any complications.The evaluation and management note should support the medical necessity of the procedure and the level of physician involvement.

** This code is for dialysis procedures other than hemodialysis.Ensure proper documentation to support the medical necessity of the dialysis procedure and any associated E&M services.Always check for payer-specific coding guidelines and local coverage determinations.

  • Revenue Code: P9A
  • Payment Status: Active
  • Modifier TC rule: Not applicable.
  • Specialties:Nephrology
  • Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center, Office
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