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CPT 90967: Short-Interval Dialysis Management for Patients Under 2
CPT code 90967 designates short-interval management of all daily dialysis services for patients younger than two years with end stage renal disease (ESRD). The code captures a distinct pediatric dialysis management scenario when care is provided for less than a full month, reflecting the intensity and coordination required for very young children with ESRD. Nationally, accurate use of this code supports proper classification of pediatric dialysis resource use and aligns claims with clinical episode timing for infants and toddlers.
Key payers considered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for pediatric ESRD dialysis management, typical sites of service, and the implications for billing and claims classification. The publication summarizes expected use cases, contrasts this short-interval management code with longer-duration dialysis management, and highlights common payer coverage considerations and coding practices. It also outlines what types of benchmarks and policy updates readers can expect to see in the full publication, including coverage patterns, reimbursement considerations across major payers, and clinical documentation elements relevant to pediatric dialysis episodes.
Data not available in the input is noted where applicable; the summary focuses on national-level implications and coding context rather than state-specific rules.
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Billing Code Overview
CPT code 90967 describes management, for less than one full month, of all daily services associated with dialysis care for a patient younger than 2 years old who has end stage renal disease (ESRD). This represents a short-interval dialysis management service specific to infants and toddlers with ESRD.
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Service type: Short-interval dialysis management for pediatric ESRD patients (under 2 years)
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Typical site of service: Inpatient pediatric nephrology units or specialized pediatric dialysis centers caring for infants and toddlers