Summary & Overview
HCPCS G9747: Palliative Dialysis with Catheter
HCPCS Level II code G9747 designates palliative dialysis delivered via a catheter for patients whose dialysis is focused on comfort and symptom management rather than curative intent. Nationally, clarity around palliative dialysis billing is important for aligning clinical goals of care with accurate claims reporting and for ensuring consistent coverage and patient access across payers. Key payers referenced include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise explanation of the clinical context for catheter-based palliative dialysis, payer coverage scope, and the operational implications for dialysis facilities and hospice programs. The publication summarizes available benchmarks and common billing modifiers, highlights policy and documentation considerations that affect claims processing, and places the code in clinical perspective for care teams involved in end-of-life renal management. Data not available in the input are noted where applicable. This overview is intended for national audiences including clinicians, billing professionals, and policy analysts seeking a practical reference on the use and administrative handling of HCPCS Level II code G9747.
Billing Code Overview
HCPCS Level II code G9747 indicates that a patient is undergoing palliative dialysis with a catheter. This code describes a palliative renal replacement therapy encounter in which dialysis is delivered via a tunneled or non-tunneled dialysis catheter rather than via a permanent arteriovenous fistula or graft.
Service type: Palliative dialysis — care focused on symptom management and comfort in patients with advanced kidney disease who are receiving dialysis primarily for quality-of-life goals.
Typical site of service: Dialysis center or outpatient dialysis clinic, with possible occurrence in inpatient settings or hospice when dialysis is continued for symptom control rather than curative intent.
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with end-stage renal disease receiving palliative hemodialysis via an indwelling tunneled dialysis catheter because curative or long-term dialysis vascular access (e.g., AV fistula) is not desired or feasible. The patient may have advanced comorbid conditions (metastatic malignancy, frailty, or limited life expectancy) and is maintained on intermittent dialysis primarily for symptom control (volume overload, uremic symptoms).
Clinical workflow: The nephrology team documents goals of care and the palliative intent for dialysis. Nursing staff verify catheter function, perform catheter site assessment and dressing changes, and establish dialysis machine setup. Vascular access nurses or interventional radiology perform catheter insertion or exchange when indicated. During each dialysis session, staff monitor hemodynamics, manage ultrafiltration to prioritize comfort, and document palliative intent in the encounter. Billing uses G9747 to reflect palliative dialysis delivered via catheter. Relevant encounter documentation includes goals-of-care notes, indications for palliative dialysis, access type (tunneled dialysis catheter), informed consent or documented shared decision-making, dialysis parameters, and any complications or catheter interventions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased Procedural Services |