In simple words: This code covers a month's worth of care for a child under 2 years old with kidney failure.The doctor or nurse sees the child at least four times during the month to check their health, help with their diet, make sure they're growing and developing well, and talk to the parents.

This code reports end-stage renal disease (ESRD)-related services provided monthly to patients younger than 2 years of age.The services encompass monitoring the adequacy of nutrition, assessing growth and development, and counseling parents or guardians.A minimum of four face-to-face visits by a physician or other qualified healthcare professional is required during the month for this code to be reported.The services bundled into this code include scheduled and episodic examinations for disease management; establishing and modifying the patient's dialysis schedule and prescription; overseeing each dialysis visit; reviewing laboratory test results, medications, and supplement needs; monitoring the patient's growth and developmental progress with intervention for delayed milestones; ongoing assessment of feeding and nutrition requirements and adjustments as necessary; telephone and electronic communications regarding the patient; and care coordination and regular counseling and support of the parents and/or caregivers and siblings. Dialysis treatment itself is not included (see codes 90935-90937 for hemodialysis).

Example 1: A 1-year-old with ESRD receives four face-to-face visits during July for dialysis oversight, medication adjustments, nutritional counseling, and growth monitoring.Code 90951 is reported., A 15-month-old with ESRD has five face-to-face visits in August, including adjustments to dialysis schedule due to growth spurts, parental counseling on dietary changes, and overall disease management.Code 90951 is reported., An 18-month-old with ESRD is seen six times in September for routine dialysis, growth assessment, and medication adjustments.Additionally, the physician addresses parental concerns about the child's development.Code 90951 is reported.

Detailed notes documenting each face-to-face visit, including the date, time, reason for visit, assessment findings, plan of care, and any interventions or counseling provided.Laboratory results, medication lists, and growth charts should also be documented.Evidence of parental counseling and support should be included in the medical record.

** Each month is considered 30 days for reporting purposes.Inpatient services should be billed separately using appropriate E/M and dialysis codes.