AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2023 Issue 3; Ask the Editor

Thrombectomy of HeRO® Graft

A patient with a thrombosed right upper extremity hemodialysis reliable outflow (HeRO®) graft underwent thrombectomy of the central aspect and cannulation segment of the graft. An AngioJet™ device was used in several passes to perform rheolytic thrombectomy throughout the graft. A Fogarty balloon was inserted and positioned in the brachial artery just beyond the arterial anastomosis. The device was activated and drawn across the anastomosis and through the graft to clear any residual thrombus. Repeat sweeping with the Fogarty balloon through the retrograde access and repeat thrombectomy with the angiocatheter was performed. Since HeRO® grafts consist of a venous outflow component (tube) in a neck vein connected to a regular dialysis graft (arterial graft component) that is anastomosed to an artery, is this thrombectomy procedure coded to the root operation Extirpation or Revision? What is the correct body part value for the thrombectomy? ...

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