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Items Tagged: vein



ZHealth Coding Newsletter - July 2020

Q & A July 2020 

Question: Embolization Dialysis Collateral Vein

Can you please let me know if I coded this correctly? The doctor says I should be able to code the cath placement into the collateral vein and the venogram. I thought it was included in the fistulogram and embolization.

US guided access into left forearm AV fistula (all documentation is there) 76937-26 fistulogram of left radiocephalic AV fistula and Central Venogram - PTA peripheral dialysis circuit in the outflow vein. 36902 Selective catheterization of lateral collateral vein arising from the peripheral juxta anastomotic outflow vein (included in embolization ?) Venogram of selected collateral forearm vein ( billable?) Embolization of selected collateral forearm vein 36909. My doctor asked me to verify with you.

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ZHealth Coding Newsletter - November 2016

November 2016 Q & A

Question: Cutting Angioplasty with Perforation

Under fluoroscopic guidance, the upper arm dialysis access fistula was catheterized and fistulogram was obtained. There was a greater than 50% stenosis within the mid cephalic vein that was dilated with an 8 mm angioplasty balloon and high pressure angioplasty balloon with no effect. The lesion was then dilated with a cutting balloon. Following angioplasty with a cutting balloon there was a leak identified from the cephalic vein. Multiple attempts at balloon tamponade were performed, and these were unsuccessful at controlling the leak. An 8 mm x 6 cm fluency stent graft was then placed across the leak and dilated to 8 mm. Follow-up fistulogram was obtained and showed free flow of contrast through the stent. Cephalic arch and central veins are patent. The arterial anastomosis is widely patent. There is a small pseudoaneurysm in the cephalic vein near the arterial anastomosis.
I am assigning codes 36147 and 37238. Should something be stated about the perforation? If so, how should this be coded?

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