AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2016 Issue 3; Ask the Editor

Insertion of Arteriovenous Graft Using HeRO Device

A 49-year-old patient on hemodialysis for end-stage renal disease presented with central vein stenosis and was taken to the operating room for creation of a left arm arteriovenous graft with a HeRO device, via the left internal jugular vein. An existing left internal jugular vein catheter was transected then used to pass a guide wire down into the inferior vena cava. The sheath with the stent graft was advanced into the superior vena cava atrial junction, then tunneled into the deltopectoral groove. An incision was made in the antecubital fossa, and the brachial artery was dissected. A graft was tunneled between the stent and the deltopectoral groove incision down to the antecubital incision. The graft was anastomosed to the brachial artery. The proximal portion was anastomosed to the graft that comes with the HeRO device. Then the connector piece was used to connect the stent graft on to the connector. What is the correct code assignment for creation of the AV graft using HeRO device via the left internal jugular vein? ...

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