How To Use CPT Code 90945

CPT 90945 describes a dialysis procedure other than hemodialysis, such as peritoneal dialysis, hemofiltration, or other continuous renal replacement therapies, with a single evaluation by a physician or other qualified health care professional. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 90945?

CPT 90945 can be used to describe a dialysis procedure other than hemodialysis, such as peritoneal dialysis, hemofiltration, or other continuous renal replacement therapies, with a single evaluation by a physician or other qualified health care professional. This code is used when the provider administers a dialysis procedure that helps remove toxic products from the blood through filtration, correct electrolyte imbalances, and restore kidney function.

2. Official Description

The official description of CPT code 90945 is: ‘Dialysis procedure other than hemodialysis (eg, peritoneal dialysis, hemofiltration, or other continuous renal replacement therapies), with single evaluation by a physician or other qualified health care professional.’

3. Procedure

1. The provider evaluates the patient and determines the need for a dialysis procedure other than hemodialysis.
2. Based on the patient’s condition, the provider selects the appropriate method for dialysis, such as peritoneal dialysis, hemofiltration, or other continuous renal replacement therapies.
3. The provider performs the chosen dialysis procedure, which may involve introducing a large volume of fluid or dialysate containing glucose into the abdomen for peritoneal dialysis, pumping the blood through a filter for hemofiltration, or using other continuous renal replacement therapies.
4. The provider replaces electrolytes, waste products, and fluid in the blood during the dialysis procedure.
5. The provider may repeat the dialysis procedure as needed to maintain kidney function and remove toxic products from the blood.

4. Qualifying circumstances

Patients eligible to receive CPT 90945 services are those who require a dialysis procedure other than hemodialysis, such as peritoneal dialysis, hemofiltration, or other continuous renal replacement therapies. The patient must undergo a single evaluation by a physician or other qualified health care professional to determine the need for the procedure. The provider must administer the dialysis procedure and monitor the patient’s condition during the process.

5. When to use CPT code 90945

CPT code 90945 should be used when a dialysis procedure other than hemodialysis is performed by a physician or other qualified health care professional, and a single evaluation is conducted. This code should not be used for hemodialysis procedures. If the dialysis procedure requires repeated evaluations or substantial revision of the dialysis prescription, CPT code 90947 should be used instead.

6. Documentation requirements

To support a claim for CPT 90945, the provider must document the following information:

• Patient’s diagnosis and the need for a dialysis procedure other than hemodialysis
• Specific dialysis method used, such as peritoneal dialysis, hemofiltration, or other continuous renal replacement therapies
• Date and time of the procedure
• Details of the procedure performed, including the volume of fluid or dialysate used, the duration of the procedure, and any additional interventions
• Monitoring of the patient’s condition during the procedure
• Signature of the physician or other qualified health care professional performing the procedure

7. Billing guidelines

When billing for CPT 90945, ensure that the procedure is performed by a physician or other qualified health care professional and includes a single evaluation. Do not report CPT 90945 for hemodialysis procedures. If the dialysis procedure requires repeated evaluations or substantial revision of the dialysis prescription, use CPT code 90947. It is important to follow the specific guidelines provided by the payer for accurate billing and reimbursement.

8. Historical information

CPT 90945 was added to the Current Procedural Terminology system on January 1, 1990. There have been two code changes since its addition, with the most recent change occurring on January 1, 2013.

9. Examples

1. A physician performing a peritoneal dialysis procedure for a patient with end-stage renal disease.
2. A qualified health care professional administering hemofiltration for a patient with acute kidney injury.
3. A physician conducting continuous renal replacement therapy for a critically ill patient in the intensive care unit.
4. A nephrologist performing a dialysis procedure other than hemodialysis for a patient with chronic kidney disease.
5. A qualified health care professional administering a dialysis procedure other than hemodialysis for a patient with electrolyte imbalances.
6. A physician conducting peritoneal dialysis for a patient with peritonitis.
7. A qualified health care professional administering hemofiltration for a patient with sepsis.
8. A nephrologist performing continuous renal replacement therapy for a patient with multiorgan failure.
9. A physician conducting a dialysis procedure other than hemodialysis for a patient with drug-induced kidney injury.