End-stage renal disease (ESRD) related services for home dialysis per full month, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents
CPT4 code
Name of the Procedure:
End-stage renal disease (ESRD) related services for home dialysis per full month, for patients aged 12-19 years. Also referred to as Home Dialysis Monthly Monitoring and Management.
Summary
This service involves comprehensive monthly care for adolescents with end-stage renal disease (ESRD) who are undergoing dialysis at home. It includes regular monitoring to ensure adequate nutrition, assessing growth and development, and counseling the patient's parents or guardians.
Purpose
Medical Condition: End-stage renal disease (ESRD).
Goals/Expected Outcomes:
- Ensure adequate dialysis and effective waste removal.
- Monitor and enhance nutritional status.
- Track and support normal growth and development.
- Provide education and support to parents or guardians.
Indications
Specific Symptoms/Conditions:
- Diagnosed with end-stage renal disease (ESRD).
- Requires dialysis for kidney function replacement.
Patient Criteria:
- Age 12-19 years.
- Suitable for home dialysis.
Preparation
Pre-Procedure Instructions:
- Maintain a balanced diet as advised by a dietitian.
- Ensure dialysis equipment is properly set up and functions correctly.
Diagnostic Tests/Assessments:
- Regular blood tests for kidney function and nutrient levels.
- Growth and development assessments by a pediatrician.
Procedure Description
Step-by-Step Explanation:
- Monthly review of the home dialysis process and outcomes.
- Nutritional monitoring through regular blood tests and diet reviews.
- Growth and development assessments through physical exams.
- Counseling sessions for parents on managing ESRD, nutritional needs, and dialysis care.
Tools/Equipment:
- Dialysis machines and associated home setup.
- Blood sampling kits.
- Growth charts and developmental tracking tools.
Anesthesia or Sedation: Not applicable.
Duration
The monitoring and management process extends over one full month, with regular check-ins and monthly comprehensive reviews.
Setting
Performed in the patient's home with regular virtual or in-person consultations as needed.
Personnel
- Nephrologist.
- Dietitian.
- Pediatrician.
- Dialysis nurse.
- Social worker or counselor.
Risks and Complications
Common Risks:
- Infections related to the dialysis site.
- Imbalanced nutrition affecting overall health.
Possible Complications:
- Complications from improper dialysis setup.
- Delayed growth or developmental issues.
Management:
- Prompt treatment of infections or complications.
- Adjustments in dialysis or nutrition plans as required.
Benefits
Expected Benefits:
- Improved treatment adherence and outcomes.
- Enhanced nutritional status and growth.
- Better overall quality of life.
Timeline: Typically, benefits are realized gradually over months.
Recovery
Post-Procedure Care:
- Regular follow-up appointments.
- Continuous at-home dialysis as per the prescribed schedule.
Expected Recovery Time: Ongoing management, no traditional recovery period.
Restrictions/Follow-Up:
- Adherence to dietary and fluid restrictions.
- Regular monitoring and adjustment of dialysis parameters.
Alternatives
Other Treatment Options:
- In-center hemodialysis.
- Kidney transplantation.
Pros and Cons:
- In-center hemodialysis may offer more controlled environments but less flexibility.
- Kidney transplantation offers potential for normal kidney function but involves surgical risks and long-term immunosuppressants.
Patient Experience
During Procedure:
- Monthly evaluations that are non-invasive.
- Regular blood tests and consultations.
After Procedure:
- Continuous monitoring without significant downtime.
- Support from healthcare professionals to manage ESRD effectively.
Pain Management/Comfort Measures: Pain is typically not a significant factor in this monitoring process. Any discomfort from blood tests or dialysis can be managed with appropriate care and support.