End-stage renal disease (ESRD) related services monthly, for patients 2-11 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 physician
CPT4 code
Name of the Procedure:
End-stage Renal Disease (ESRD) Related Services Monthly for Patients Aged 2-11 Years with Monitoring, Assessment, and Counseling
Summary
End-stage renal disease (ESRD) related services for children aged 2-11 years include regular monitoring of nutrition, assessment of growth and development, and counseling for parents to manage the child's health. This service involves multiple face-to-face visits with a physician to ensure comprehensive care.
Purpose
Medical Condition Addressed: End-stage renal disease (ESRD), where the kidneys can no longer function properly.
Goals and Expected Outcomes:
- Ensure adequate nutrition for the child's health and development.
- Regularly assess the child's growth and adjust treatments as necessary.
- Provide parents with counseling and support to effectively manage the child's condition.
Indications
Specific Symptoms or Conditions:
- Diagnosis of end-stage renal disease (ESRD).
- Symptoms of poor growth or malnutrition due to ESRD.
Patient Criteria:
- Children aged 2-11 years diagnosed with ESRD.
- Patients requiring comprehensive monthly care.
Preparation
Pre-procedure Instructions:
- Ensure the child follows prescribed dietary and fluid restrictions.
- Schedule all necessary blood tests and imaging studies as per the physician’s instructions before visits.
Required Diagnostic Tests:
- Regular blood tests to monitor kidney function and nutritional status.
- Growth measurements and possibly imaging studies to assess development.
Procedure Description
Steps Involved:
- Face-to-Face Visits: The physician meets with the child and parents at least four times a month.
- Monitoring Nutrition: Review dietary intake, conduct blood tests, and make necessary nutritional plan adjustments.
- Growth and Development Assessment: Measure height, weight, and developmental milestones; compare against growth charts.
- Parental Counseling: Educate and support parents in managing the child’s condition, covering topics such as medication, dialysis (if applicable), and lifestyle adjustments.
Tools and Equipment:
- Growth charts
- Nutritional assessment tools
- Blood pressure monitors
- Laboratory facilities for blood tests
Anesthesia or Sedation:
- Not typically required for routine visits and assessments.
Duration
- Each face-to-face visit may last between 30 minutes to 1 hour.
- Total monthly time may vary based on individual needs and specific issues addressed.
Setting
- Typically conducted in an outpatient clinic or specialized renal care center.
Personnel
- Pediatric nephrologist
- Dietitian
- Nurse or medical assistant
- Social worker or counselor for parental support
Risks and Complications
Common Risks:
- Discomfort from blood tests or nutritional assessments.
- Emotional stress for both the child and parents.
Rare Risks:
- Potential complications from adjusting treatment plans, such as dietary changes causing temporary discomfort.
Management:
- Regular follow-up and coordination with healthcare providers to manage any arising issues.
Benefits
- Improved nutritional status and growth.
- Better management of ESRD symptoms.
- Enhanced parental knowledge and ability to care for the child.
Realization of Benefits:
- Most benefits are ongoing and will become evident over months of consistent care.
Recovery
Post-Procedure Care:
- Continued adherence to dietary and medication plans as prescribed.
- Regular follow-up visits to monitor progress.
Recovery Time:
- Ongoing management, as ESRD is a chronic condition.
Restrictions and Follow-Up:
- Age-appropriate activities encouraged.
- Follow-up appointments as recommended by the physician.
Alternatives
Other Treatment Options:
- Dialysis: Hemodialysis or peritoneal dialysis if necessary.
- Kidney Transplant: Considered in severe cases and when a suitable donor is available.
Pros and Cons of Alternatives:
- Dialysis requires regular sessions and can be burdensome.
- Kidney transplant offers a possible long-term solution but involves waiting for a donor and potential surgical risks.
Patient Experience
During the Procedure:
- Regular visits may involve routine checks, blood draws, and discussions.
- Minimal physical discomfort, with a focus on empathetic care.
After the Procedure:
- Routine blood tests and monitoring may cause brief discomfort.
- Continuous support and guidance from healthcare professionals to manage living with ESRD.
Pain Management and Comfort Measures:
- Use of topical numbing agents for blood draws if necessary.
- Psychological support for the child and family to cope with the chronic condition.