CPT® Code 0603T

Official Description

Glomerular filtration rate (GFR) monitoring, transdermal, including sensor placement and administration of more than one dose of fluorescent pyrazine agent, each 24 hours

Common Language Description

Glomerular filtration rate (GFR) monitoring is a critical procedure used to assess kidney function through a noninvasive method. This process utilizes a transdermal sensor device that allows for real-time monitoring of renal function, which is essential for managing kidney disease and preventing misdiagnosis related to the staging of kidney conditions. Unlike traditional methods that rely on estimating GFR through blood tests, which can be influenced by various factors and may not provide timely or accurate reflections of kidney health, transdermal GFR monitoring offers a more immediate and precise measurement. The procedure involves the placement of a sensor on the skin, which is secured with a medical-grade adhesive after preparing the site by cleansing and shaving. A fluorescent pyrazine agent is administered, either as a single intravenous bolus for immediate measurement or in multiple doses over a 24-hour period for extended monitoring. This agent disperses into the extracellular space and is subsequently cleared by the kidneys, allowing the sensor to detect and analyze the fluorescent light emitted from the tracer. The data collected is processed and converted into a digital readout, providing healthcare professionals with valuable insights into the patient's renal function in real time.

1. Indications

GFR monitoring is indicated for the following conditions:

Kidney Function Assessment This procedure is performed to evaluate the overall function of the kidneys, particularly in patients with known or suspected kidney disease.
Monitoring of Kidney Disease It is utilized to track the progression of kidney disease over time, allowing for timely interventions and adjustments in treatment plans.
Prevention of Staging Misdiagnosis GFR monitoring helps prevent misdiagnosis related to the staging of kidney disease, ensuring that patients receive appropriate care based on accurate renal function assessments.

2. Procedure

The procedure for GFR monitoring involves several key steps that ensure accurate measurement of kidney function:

Step 1: Site Preparation The skin area where the transdermal sensor will be placed is thoroughly cleansed and shaved to ensure proper adhesion and accurate readings. This preparation is crucial for minimizing any interference that could affect the sensor's performance.
Step 2: Sensor Placement After preparing the site, the transdermal sensor is attached to the skin using a medical-grade two-sided adhesive. This sensor is designed to remain securely in place while it collects data on the fluorescent tracer agent.
Step 3: Administration of Tracer Agent The fluorescent pyrazine agent is administered either as a single intravenous bolus injection for immediate GFR measurement or in multiple doses, each spaced 24 hours apart, for ongoing monitoring. The choice of administration depends on the clinical need for either a snapshot of kidney function or continuous assessment.
Step 4: Data Collection Once the tracer is administered, it distributes into the extracellular space and is cleared by the kidneys. The transdermal sensor, equipped with a fiber optic bundle, detects the backscattered light and the fluorescent light emitted from the tracer. This data is then amplified and converted from analog to a digital readout using custom software.

3. Post-Procedure

After the GFR monitoring procedure, the patient may be observed for any immediate reactions to the tracer agent. The duration of monitoring can vary based on the patient's kidney health and the specific protocol followed. Continuous monitoring may be conducted for up to 24 hours, depending on the administration of the tracer agent. Healthcare providers will analyze the digital readouts generated by the sensor to assess kidney function and make informed decisions regarding the patient's care. Follow-up appointments may be scheduled to discuss the results and any necessary adjustments to treatment plans based on the findings from the GFR monitoring.

Short Descr	TRANSDERMAL GFR MONITORING
Medium Descr	TDRM GFR MNTR SNR PLMT&>1 DOS PYRAZINE EA 24 HRS
Long Descr	Glomerular filtration rate (GFR) monitoring, transdermal, including sensor placement and administration of more than one dose of fluorescent pyrazine agent, each 24 hours
Status Code	Carriers Price the Code
Global Days	YYY - Carrier Determines Whether Global Concept Applies
PC/TC Indicator (26, TC)	0 - Physician Service Code
Multiple Procedures (51)	0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50)	0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62)	0 - Co-surgeons not permitted for this procedure.
Team Surgery (66)	0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	Conditionally packaged laboratory tests
Berenson-Eggers TOS (BETOS)	none
MUE	1