Dialysis procedure at a medicare certified esrd facility for acute kidney injury without esrd
HCPCS code
Dialysis Procedure at a Medicare-Certified ESRD Facility for Acute Kidney Injury without ESRD (G0491)
Name of the Procedure:
Common Name: Dialysis
Medical Term: Dialysis for Acute Kidney Injury (AKI) without End-Stage Renal Disease (ESRD)
Summary
Dialysis is a treatment that performs the function of the kidneys when they are unable to do so. This procedure is used to remove waste, salt, and extra water to prevent them from building up in the body, stabilize electrolyte levels, and help control blood pressure in patients suffering from acute kidney injury but who do not have end-stage renal disease.
Purpose
Medical Conditions Addressed:
- Acute Kidney Injury (AKI) without ESRD
Goals/Expected Outcomes:
- Removal of waste products and excess fluids from the blood
- Stabilization of electrolyte balance
- Prevention of further complications related to AKI
Indications
Symptoms or Conditions:
- Decreased urine output
- Swelling in legs, ankles, and feet due to fluid retention
- Fatigue and weakness
- Nausea and vomiting
Patient Criteria:
- Diagnosed with acute kidney injury (AKI)
- Not suffering from end-stage renal disease (ESRD)
- Requiring assistance for waste removal and fluid balance
Preparation
Pre-procedure Instructions:
- Fasting may be required several hours before the procedure
- Adjustments to medications as directed by the physician
- Complete necessary diagnostic tests such as blood tests and imaging studies
Diagnostic Tests:
- Blood work to assess kidney function and electrolyte levels
- Imaging studies if required to locate vascular access points
Procedure Description
Steps Involved:
- Access Creation: Insertion of a catheter into a vein, typically in the neck or groin.
- Blood Flow: Patient’s blood is transferred to a dialysis machine using a series of tubes.
- Filtration: The dialysis machine filters waste products, excess salts, and fluids from the blood.
- Return of Clean Blood: The cleaned blood is returned to the patient’s body through the tubing system.
Tools and Equipment:
- Dialysis machine
- Catheters
- Tubing system
Anesthesia/Sedation:
- Typically, local anesthesia or sedation is not required.
Duration
The procedure typically takes about 2 to 4 hours, conducted multiple times a week based on the patient's condition.
Setting
The procedure is performed in a Medicare-certified ESRD facility designed for dialysis treatment.
Personnel
Involved Healthcare Professionals:
- Nephrologist (kidney specialist)
- Dialysis nurses and technicians
- Support staff for monitoring and assistance
Risks and Complications
Common Risks:
- Low blood pressure
- Muscle cramps
- Nausea and vomiting
Rare Complications:
- Infection at the access site
- Blood clots
- Sepsis
Management:
- Constant monitoring by healthcare professionals
- Immediate intervention if any complications arise
Benefits
Expected Benefits:
- Improvement in blood chemistry
- Reduction of fluid overload
- Relief of symptoms associated with kidney injury
Realization Timeline:
- Benefits typically observed within a few sessions
Recovery
Post-Procedure Care:
- Monitoring of vital signs
- Hydration management
- Regular follow-up appointments with the nephrologist
Recovery Time:
- Varies by individual but generally swift
Restrictions/Follow-Up:
- Limited physical activity immediately post-procedure
- Periodic assessments and continued dialysis if needed until kidney function improves
Alternatives
Other Treatment Options:
- Conservative management with medications
- Peritoneal dialysis as another form of dialysis
Pros and Cons:
- Conservative management may delay waste removal
- Peritoneal dialysis can be performed at home but involves different risks
Patient Experience
During Procedure:
- May feel a bit cold or tired
- Some mild discomfort possible at the site of catheter insertion
After Procedure:
- Fatigue is common
- Possible dizziness due to fluid removal
Pain Management/Comfort Measures:
- Pain relievers for discomfort at the access site
- Warm blankets to combat feeling cold during dialysis
Patients will often be cared for by a dedicated nursing team, ensuring a supportive and comfortable environment throughout the procedure.