End-stage renal disease (ESRD) related services monthly, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face visits by a
CPT4 code
Name of the Procedure:
Monthly End-stage Renal Disease (ESRD) Related Services for Patients Younger than 2 Years of Age
Common names: Pediatric ESRD monthly services
Medical terms: Pediatric End-Stage Renal Disease (ESRD) management
Summary
Monthly ESRD-related services for infants and toddlers younger than 2 years monitor kidney function, ensure adequate nutrition, assess growth and development, and provide counseling to parents. These services include a minimum of four face-to-face visits each month with healthcare providers.
Purpose
Medical Condition: End-stage renal disease (ESRD) Goals: To manage and monitor ESRD in young children, ensure proper growth and development, maintain adequate nutrition, and provide essential support and counseling to parents.
Indications
Symptoms or Conditions: Diagnosis of ESRD, poor kidney function, failure to thrive, nutritional deficiencies, slow growth or developmental delays. Patient Criteria: Children younger than 2 years diagnosed with ESRD needing intensive, ongoing management.
Preparation
Pre-procedure Instructions: No specific preparation is generally required for these routine visits. Diagnostic Tests: Regular blood tests, growth measurements, nutritional assessments, and developmental screenings.
Procedure Description
- Monitoring of Kidney Function: Regular blood tests to check kidney function and electrolyte balance.
- Nutritional Assessment: Evaluation of dietary intake, weight gain, and nutritional needs.
- Growth and Development Assessment: Monitoring height, weight, and developmental milestones.
- Parental Counseling: Providing education, support, and guidance to parents regarding their child's condition and care needs.
- Face-to-Face Visits: At least four visits per month with a healthcare provider to cover the aforementioned assessments and counseling.
Tools/Equipment: Blood draw kits, scales, growth charts, feeding/nutrition assessments. Anesthesia/Sedation: Not typically required.
Duration
Each visit lasts about 30–60 minutes, depending on the specific assessments and discussions needed.
Setting
Typically performed in an outpatient clinic specializing in pediatric nephrology or general pediatric care.
Personnel
- Healthcare Providers:* Pediatric nephrologist, pediatric nurse, dietitian, developmental specialist.
Risks and Complications
Common:* Minor discomfort from blood draws. Rare:* Allergic reactions to supplements or medications, infection at blood draw site.
Benefits
Expected Benefits: Effective management of ESRD, improved growth and development, better nutritional status, and well-supported parents. Timeline: Benefits can be observed with regular monitoring and adequate care provided each month.
Recovery
Post-procedure Care: Routine follow-up visits, adherence to nutritional and medical guidelines. Recovery Time: Ongoing management rather than a single recovery period; continuous monitoring required. Restrictions/Follow-up: Scheduled monthly visits and any necessary dietary adjustments.
Alternatives
Other Options: Dialysis or kidney transplant (if suitable), nutritional supplements, home-based follow-up. Pros/Cons of Alternatives: More invasive or intensive, requires skilled care, potential complications higher.
Patient Experience
During Procedure: Routine interaction with healthcare providers; non-invasive. After Procedure: Parents will likely receive detailed instructions for home care; children will undergo routine monitoring with minimal discomfort. Pain Management and Comfort: Blood draw discomfort managed with topical numbing agents; overall, the visits are designed to be as comfortable and child-friendly as possible.