Please note this question was answered in 2018. The coding advice may or may not be outdated.
LT AVF thrombectomy with brachio-brachial graft other than vein
Question:
I am needing some guidance. I'm unsure how to code this case. Are codes 36831 and 37799 correct? "Longitudinal incision made in graft, #4 Fogarty catheter placed both proximal and distal and antegrade bleeding was established. Retrograde bleeding could not. Fistulogram obtained and noted total occlusion of venous outflow and brachial artery proximal to the anastamosis. After multiple failed attempts to cross the total occlusion of the venous occlusion it was elected to address arterial inflow. Further exposure obtained of brachial artery, control obtained proximal and distal to the anastamosis. Anastomosis was open and noticed patient had significant fibromuscular hyperplasia. Patient had friable artery with an area of small disruption. It was elected to remove that portion of artery and treat with an interposition 5 mm Gore-Tex graft. Brachial artery was transected proximal and distal to previous anastamosis. An end-to-side was accomplished both proximal and distal with a running 6-0 prolene. Flow established, patient had palpable pulse, wound irrigated and closed in double layered fashion."
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