AHA Coding Clinic® for HCPCS - 2024 Issue 2; Ask the Editor

Dialysis circuit procedures with HCPCS Level II and CPT codes

A patient with end-stage renal disease (ESRD) on hemodialysis via an arteriovenous fistula (AVF), experiences hyperpulsatility of their AVF. Access was accomplished with a micro-access system in the direction of the venous outflow. A coaxial dilator was placed through this dilator and a fistulogram was performed which identified 70% stenosis in both the cephalic arch and brachiocephalic vein. Once the fistulogram was complete, a guidewire was placed and over this a venous sheath was inserted and a balloon angioplasty was performed in the stenosed cephalic arch and the brachiocephalic vein. The post intervention stenosis for both was 30%.For Ambulatory Surgical Center (ASC) reporting, can HCPCS code C7513 and CPT code 36902 both be reported together to capture the balloon angioplasties performed to treat the stenoses of the central dialysis segment and the peripheral dialysis segment? Or would HCPCS code C7513 be reported for each segment, if it is the correct code for the procedures performed? ...

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