CPT Code 90955 | Description & Clinical Information

CPT 90955 describes the comprehensive management of all services required for the monthly care of a patient aged between 2 and 11 years old with end stage renal disease, where the provider conducts face-to-face visits with the patient two to three times during the month to ensure the necessary care is provided.

Official Description

The CPT book defines CPT code 90955 as: “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 2-3 face-to-face visits by a physician or other qualified health care professional per month”.

Clinical Information

The procedure described by the CPT code 90955 is an outpatient service that caters to a specific group of patients aged 2 to 11 years who are suffering from End-Stage Renal Disease (ESRD). The provider manages all ESRD related services for a period of one month, providing essential care to the patient during this time.

The provider is required to see the patient two to three times during the month, giving the patient the much-needed face to face interaction to help manage their condition effectively. This care is bundled into the CPT code 90955, and it includes critical services such as scheduled and episodic examinations for the management of the disease.

The provider is tasked with establishing and changing the patient’s dialysis schedule and prescription, oversight of each dialysis visit, reviewing laboratory tests, medication, and supplement needs. They also monitor the patient’s growth and developmental progress, intervening where necessary, ongoing assessment of nutrition requirements and adjustments as necessary, and school progress monitoring.

The CPT code 90955 also incorporates telephone and electronic communication regarding the patient, care coordination, and regular counseling and support of the parents and caregivers, and siblings. The provider plays a vital role in ensuring that the patient is well taken care of throughout the treatment process by addressing the needs of the patient and their family.

By managing all aspects of the patient’s care, the provider can better manage the patient’s health condition and enhance their quality of life, which is the ultimate goal of CPT code 90955. This procedure ensures that the patient receives the required treatment and care during the monthly period, enabling them to improve their health and overall well-being.

The ESRD-related services offered by the provider through CPT code 90955 are essential, particularly for young patients who require specialized care. The procedure is a testimony to the dedication of healthcare professionals who work tirelessly to improve the quality of life of patients with chronic diseases. Their commitment and hard work have been vital in managing the disease burden and improving patient outcomes.

In conclusion, CPT code 90955 is a comprehensive outpatient service that provides high-quality care to patients suffering from End-Stage Renal Disease. The procedure is crucial in managing ESRD and its associated complications effectively. Through this procedure, patients are assured of getting the necessary care and support during their treatment process, enhancing their health condition and improving their overall quality of life.

Return to all the CPT codes for end-stage renal disease services.

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