Ask Dr. Z

"A patient underwent creation of a brachiocephalic AVF. After construction, thrill in the fistula was noted to be weak. The anastomosis was taken down and fresh thrombus was seen at the anastomotic site. This was removed and flushed away with heparinized saline. Then thrombectomy of the brachial artery was performed with a Fogarty catheter. The artery was flushed. A Fogarty catheter was passed into the cephalic vein and a small amount of thrombus was extracted. The vein was flushed. The anastomosis was redone." How would this procedure be coded? Would the thrombectomy be considered part of the AVF creation, or is it separately reportable?