End-stage renal disease (ESRD) related services monthly, for patients 20 years of age and older; with 1 face-to-face visit by a physician or other qualified health care professional per month
CPT4 code
Name of the Procedure:
End-stage Renal Disease (ESRD) Monthly Services
Common names: ESRD monthly management, Renal disease maintenance.
Technical Term: ESRD-related services monthly.
Summary
Patients aged 20 and older with End-stage Renal Disease (ESRD) receive monthly care which includes at least one face-to-face visit with a physician or other qualified healthcare professional. The care involves comprehensive management and monitoring of the ESRD condition to ensure optimal treatment outcomes.
Purpose
The primary goal of monthly ESRD services is to manage and monitor patients with end-stage renal disease effectively. This includes overseeing dialysis treatments, adjusting medications, addressing complications, and providing ongoing support to improve patient quality of life and reduce hospitalizations.
Indications
- Diagnosed with end-stage renal disease (ESRD).
- Undergoing regular dialysis (hemodialysis or peritoneal dialysis).
- Age 20 years or older.
- Requiring ongoing medical management and monitoring.
Preparation
- Follow regular dialysis schedule.
- Maintain a log of any symptoms or unusual changes.
- Bring a list of current medications and dosages.
Procedure Description
- Initial Assessment: The physician reviews the patient’s medical history, dialysis records, and current health status.
- Physical Examination: Conduct a comprehensive physical examination.
- Review of Dialysis: Evaluate dialysis efficiency, monitor lab results, and assess vascular access if applicable.
- Management Plan Update: Adjust medications, recommend lifestyle changes, and address any new or ongoing concerns.
- Documentation: Thoroughly document the visit and any changes made in the patient's management plan.
Duration
The face-to-face visit typically lasts 30 minutes to 1 hour, with the total monthly services spanning several hours when considering continuation of care between visits.
Setting
The procedure is performed in an outpatient clinic or a dialysis center.
Personnel
- Primary care physician or nephrologist.
- Nurse or medical assistant.
- Dietitian and social worker may also be involved.
Risks and Complications
- Access site infections or complications related to dialysis.
- Potential medication side effects or interactions.
- Not adhering to medical advice may lead to worsened health outcomes.
Benefits
- Improved management of ESRD.
- Enhanced quality of life with appropriate treatment adjustments.
- Reduction in hospitalization or emergency care needs.
Recovery
- Most patients can resume their regular activities immediately following the visit.
- Follow-up appointments and continuous communication with healthcare providers are essential.
- Adherence to prescribed treatments and lifestyle recommendations is crucial.
Alternatives
- Home-based dialysis with remote monitoring.
- Palliative care for patients with significant comorbidities or those opting not to continue aggressive treatment.
- Kidney transplantation as a potential definitive treatment.
Patient Experience
During the visit, patients may feel reassured and supported as their health is closely monitored and managed. Some discomfort may be associated with physical examinations or dialysis access site inspections. Pain management is typically addressed, and comfort measures are provided throughout the care.