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20/01/2021

Hemodialysis

 

 

For Members:

 

What is Hemodialysis?

Hemodialysis is a process where a machine filters wastes, salts and fluid from the blood when the kidneys are not healthy to function regularly, for example, kidney failure. It helps in controlling the blood pressure and maintaining the proper balance of fluid and minerals in the body. Hence, improving the quality of life.

Measurement of kidney function provides the information to plan the hemodialysis. Your treating physician measures the kidney function by using ‘estimated Glomerular Filtration Rate’ (eGFR). The calculation of eGFR is based on the creatinine blood level, gender, age and any underlying disease, for example, diabetes.

Hemodialysis is a serious responsibility, where you have to:

  • Take medications regularly as prescribed by the treating Physician.
  • Strictly follow a treatment schedule with regular follow-up with Kidney Doctor.
  • Make changes in the diet, especially fluid intake.

 

 

What are the Indications?

Hemodialysis is performed in the following conditions:

  • Decreased Kidney Function with fluid overload
  • Kidney Failure
  • eGFR of 5 to 7 ml/min/1.73 m2 but this range may vary according to the age.

 

What are the common risks/complications of Hemodialysis?

  • Low Blood Pressure
  • Generalised Weakness
  • Muscle & Leg Cramps
  • Itching
  • Nausea and vomiting
  • Headache
  • Sleeping problems
  • Mood Changes (Anxiety or Depression)
  • Anaemia
  • Chest and Back pain
  • Infection or blockage at the access site

 

Preparation for hemodialysis:

For a planned Hemodialysis, your physician will prepare a permanent access to your blood stream after informed consent form is signed by you. The access provides a mechanism for a small amount of blood to be safely removed from your circulation and then returned to you in order for the hemodialysis process to work. Adequate time should be given for the healing and stabilizing of the access site.

For emergency Hemodialysis, a plastic tube (catheter) may be inserted into a large vein, either in your neck or near your groin. The catheter is temporary.

 

 

 

For Healthcare Providers:

 

 

CPT Description
90935 Hemodialysis procedure with single physician evaluation
90937 Hemodialysis procedure requiring repeated evaluation(s)
20.10 Hemodialysis on outpatient basis per session
90945 Peritoneal Dialysis with single physician evaluation
90947 Peritoneal Dialysis requiring repeated evaluations with
14-01 * Perdiem – Hemodialysis  (HD)

*14-01 Per Diem-Haemodialysis (HD). Daily all-inclusive rate for out-patient hemodialysis in a dialysis centre provided for a patient. Which shall include:

  • Initial and Routine patient assessment prior to, during or after in-centre dialysis treatment.
  • Performance of hemodialysis.
  • Patient education and support concerning renal disease, dialysis treatment, diet, lifestyle and social aspects.
  • Equipment required for the performance of the Hemodialysis.
  • All disposable products and supplies required for the performance of the Haemodialysis.
  • Medical supervision of the dialysis by qualified physician.
  • Pharmaceuticals which are required in the performance of the dialysis treatment.
  • All routine investigation tests required for hemodialysis.

 

Recommendations:

  • All Haemodialysis/ Peritoneal Dialysis sessions require pre-approval from Nextcare.
  • Haemodialysis for the treatment of schizophrenia experimental and investigational because the effectiveness of this treatment has not been demonstrated.
  • CPT 90935 cannot be approved in combination with codes 14-01 or 20.10 because the services already included in it.

References: