End-stage renal disease (ESRD) related services monthly, for patients 20 years of age and older; with 4 or more face-to-face visits by a physician or other qualified health care professional per month
CPT4 code
Name of the Procedure:
End-Stage Renal Disease (ESRD) Related Services Monthly
Common name(s): ESRD Monthly Care, Kidney Failure Management
Summary
Patients who have end-stage renal disease (kidney failure) often need continuous care. For adults aged 20 or older, this includes monthly services with at least four face-to-face visits from a physician or qualified health care professional.
Purpose
Addressed Condition: End-Stage Renal Disease (ESRD) Goals/Outcomes:
- Manage and monitor kidney function and overall health.
- Adjust and optimize ongoing treatment plans.
- Early identification and management of complications.
Indications
- Diagnosed with End-Stage Renal Disease.
- Requiring dialysis or transplant preparation.
- Complex medical needs due to ESRD.
Preparation
Pre-visit Instructions:
- Maintain existing dialysis schedule.
- List all current medications.
- No specific fasting required, unless specified by your healthcare provider.
Diagnostic Tests:
- Routine blood tests (e.g., electrolyte levels, kidney function markers).
- Regular monitoring of blood pressure and weight.
Procedure Description
- Initial Consultation:
- Review patient’s history and current health status.
- Physical examination.
- Monthly Visits:
- Minimum of four face-to-face visits, each tailored to the patient’s needs.
- Monitoring vital signs and reviewing lab results.
- Consultation on medication adjustments and diet.
- Discuss lifestyle changes and offer mental health support.
- Managing dialysis access sites and potential issues.
Tools Used:
- Blood pressure cuffs, stethoscopes, blood sample kits.
Anesthesia: Not applicable.
Duration
Each visit typically lasts 30-60 minutes, depending on the patient’s needs.
Setting
These visits can be performed in various settings, including:
- Outpatient clinics.
- Dialysis centers.
- Hospital outpatient departments.
Personnel
- Physicians specializing in nephrology.
- Registered nurses.
- Dietitians.
- Social workers and mental health professionals if required.
Risks and Complications
- Common Risks: Minor discomfort during blood draws.
- Rare Risks: Infection at access sites, missed complications if visits are too infrequent.
- Management: Prompt follow-up with concerns.
Benefits
- Enhanced management of ESRD.
- Improved quality of life.
- Prevention or early detection of complications.
- Potential stabilization of kidney function.
Recovery
- No specific recovery period.
- Routine lifestyle with careful attention to dietary and medication adherence.
- Regular follow-up appointments as scheduled.
Alternatives
- Less frequent visits: May lead to inadequate monitoring.
- Self-management: Possible, but less recommended due to complexity.
- Increased in-person care: More frequent visits, if needed based on patient condition.
Pros and Cons of Alternatives:
- Less frequent visits may lower burden but increase risks.
- Self-management places more responsibility on patient.
- Increased care could be more comprehensive but time-consuming.
Patient Experience
During the Procedure:
- Generally, non-invasive and involves regular check-ups.
- Clearly communicate any symptoms or concerns.
After the Procedure:
- Patients are encouraged to maintain open communication with their healthcare team.
- Pain management is minimal, usually involving managing any discomfort from blood draws.
Comfort Measures:
- Open dialogue with the healthcare provider.
- Support from the care team to address any concerns or discomfort.