2025 CPT code 90947
(Active) Effective Date: N/A Revision Date: N/A Medicine - Dialysis Services and Procedures Feed
Dialysis procedure other than hemodialysis requiring repeated evaluations by a physician, with or without substantial revision of dialysis prescription.
Modifier 25 can be used with evaluation and management codes for separately identifiable services unrelated to the procedure or renal failure that cannot be rendered during the dialysis session.
Medical necessity for this code must be supported by documentation of the patient's end-stage renal disease (ESRD) and the need for repeated physician evaluations during the dialysis procedure due to complications or the need for prescription adjustments.
The physician is responsible for evaluating the patient repeatedly during the dialysis procedure and making any necessary revisions to the dialysis prescription. The physician must be present and actively involved in the patient's care during the dialysis session.
In simple words: This code covers a type of dialysis, different from the usual hemodialysis, that needs a doctor to check the patient multiple times during the procedure and possibly change the treatment plan.
This code describes a dialysis procedure other than hemodialysis (e.g., peritoneal dialysis, hemofiltration, or other continuous renal replacement therapies) that requires repeated evaluations by a physician or other qualified healthcare professional, with or without substantial revision of the dialysis prescription.
Example 1: A patient receiving peritoneal dialysis experiences difficulty with fluid drainage. The physician evaluates the patient multiple times during the session, adjusts the dialysate concentration, and monitors the patient's response., A patient undergoing hemofiltration develops hypotension. The physician evaluates the patient, adjusts the filtration rate, and provides additional fluids and medications as needed., A patient on continuous renal replacement therapy experiences electrolyte imbalances. The physician evaluates the patient repeatedly, orders blood tests, and adjusts the replacement fluid composition to correct the imbalances.
Documentation should include the type of dialysis performed, the frequency and duration of physician evaluations, any changes made to the dialysis prescription, the patient's response to treatment, and any complications encountered.
- Specialties:Nephrology
- Place of Service:Inpatient Hospital, Home, Outpatient Hospital