AHA Coding Clinic® for HCPCS - 2021 Issue 4; Ask the Editor

Revision of an arteriovenous fistula

A dialysis patient with a left wrist arteriovenous (AV) fistula for eight years presented with thrombus in the antecubital vein. Prior to thrombectomy of the antecubital vein, an AV fistula was created in the left upper arm/antecubital fossa. An incision was made in the elbow crease and the brachial artery was dissected. The cephalic vein was measured for adequate length to reach the brachial artery. The thrombosed portion of the antecubital vein was tied off and secured distally. The vein was clamped at the antecubital/cephalic tract as it exited the incision of the upper arm. The vein was then divided. A small frond of thrombus extending into the antecubital vein towards the cephalic tract, which would become the upper arm fistula, was peeled away leaving 80% of the vein without thrombus. The vein was spatulated and prepared for anastomosis. An arteriotomy was made on the brachial artery and the antecubital/cephalic vein was brought into anastomosis with the arteriotomy creating the fistula. Would this be considered a revision to the existing fistula and reported with CPT code 36833, or is the relocation of the fistula from the wrist to the upper arm/antecubital fossa considered creation of a new fistula and reported with CPT code 36821? ...

To read the full article, sign in and subscribe to the AHA Coding Clinic® for HCPCS.


The AHA Coding Clinic for HCPCS includes:

  • The official publication for Level I HCPCS (CPT-4 codes) for hospital providers
  • Also specific Level II HCPCS codes for hospitals, physicians and other health professionals
  • Current newsletters added each quarter
  • Full Archives back to 2001
  • Fully searchable through Find-A-Code's Comprehensive Search
  • Codes mentioned in articles are linked to Code Information pages
  • Code Information page link back to related articles
  • View all the articles associated with any code, right from the code page!
Access to this feature is available in the following products:
  • AHA's Coding Clinic® - HCPCS +Archives

demo
request yours today
subscribe
start today
newsletter
free subscription

Thank you for choosing Find-A-Code, please Sign In to remove ads.