How To Use CPT Code 90997

CPT 90997 describes the process of hemoperfusion, which involves removing toxic substances from a patient’s blood using a charcoal or resin material. 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 90997?

CPT 90997 can be used to describe the medical process of hemoperfusion, which is used to remove toxic substances from a patient’s blood. This technique involves passing large volumes of blood over an adsorbent substance, such as activated charcoal or resin, to cleanse the blood of harmful substances.

2. Official Description

The official description of CPT code 90997 is: ‘Hemoperfusion (eg, with activated charcoal or resin).’ This code is used to report the procedure of removing toxic substances from the blood using an adsorbent material.

3. Procedure

1. In preparation for hemoperfusion, the patient is fitted with two catheters, one in an artery and the other in a large vein in the same arm.
2. The catheters are connected to a treatment unit, which includes a column of adsorbent material, such as activated charcoal or resin.
3. Throughout the treatment, the patient is given small doses of heparin to prevent blood clotting.
4. The patient’s blood is drawn from the artery catheter and pumped through the column of adsorbent material, which removes toxic substances and lipid soluble drugs.
5. The cleansed blood is then transfused back into the patient’s body using a needle and catheter connected to the vein catheter.

4. Qualifying circumstances

CPT 90997 is used for patients who require hemoperfusion to remove toxic substances from their blood. This procedure can be performed on patients with or without renal failure and is often used in the treatment of life-threatening drug overdoses. It is important to note that the procedure must be performed by a qualified healthcare professional.

5. When to use CPT code 90997

CPT code 90997 should be used when a patient undergoes hemoperfusion to remove toxic substances from their blood using activated charcoal or resin. It is important to ensure that the procedure is medically necessary and performed by a qualified healthcare professional.

6. Documentation requirements

To support a claim for CPT 90997, the healthcare professional must document the following information:

• Reason for performing hemoperfusion
• Details of the procedure, including the use of activated charcoal or resin
• Date and duration of the procedure
• Any complications or adverse reactions
• Signature of the healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT 90997, ensure that the procedure is performed by a qualified healthcare professional and that the documentation requirements are met. It is important to follow the specific guidelines provided by the payer to ensure accurate and timely reimbursement. Additionally, consider any applicable modifiers or additional codes that may be required for proper billing.

8. Historical information

CPT 90997 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient with severe drug overdose undergoes hemoperfusion to remove toxic substances from their blood.
2. A patient with renal failure requires hemoperfusion to cleanse their blood of harmful substances.
3. A patient with a life-threatening toxin exposure undergoes hemoperfusion as part of their treatment.
4. A patient with acute liver failure undergoes hemoperfusion to remove toxins from their bloodstream.
5. A patient with a drug-resistant infection undergoes hemoperfusion to remove antibiotics from their blood.
6. A patient with severe sepsis requires hemoperfusion to remove endotoxins from their bloodstream.
7. A patient with acute kidney injury undergoes hemoperfusion to remove toxins and waste products from their blood.
8. A patient with a rare genetic disorder requires hemoperfusion to remove excess metabolites from their bloodstream.
9. A patient with severe poisoning undergoes hemoperfusion to remove toxic substances from their blood.
10. A patient with a drug allergy undergoes hemoperfusion to remove the offending drug from their bloodstream.