Ask Dr. Z

"Patient has a brachiocephalic fistula. The left cephalic vein fistula was accessed antegrade. The sheath was used to inject contrast to perform fistulogram. Retrograde injection was performed with a balloon occlusion of the fistula, which revealed ~90% stenosis of the proximal fistula vein ~2 cm distally to the AV anastomosis. Left radial artery was then accessed at the wrist under local anesthesia and ultrasound guidance. Wire and catheter were unable to access the fistula from this location. Therefore retrograde fistula access in the proximal upper arm was obtained under ultrasound guidance and with local anesthesia. The stenosis was angioplastied with a balloon with good result." Can we code for the radial artery attempted access? Would 36140-59 be correct in addition to 36902?