Ask Dr. Z

I have my provider billing a revision (36832) for aneurysmal resection with ulcerations. He notes that there was no penetration into the fistula wall. Would this support a revision? My gut is telling me no, but I want to be certain. "Patient had 2 aneurysmal areas on the fistula with ulcerations on top of the aneurysm. At this point in time elliptical incision was made and surrounding the area of the aneurysms. The aneurysms are resected. There is no penetration into the AV fistula wall for which reason the wounds were both closed in a double layered fashion with absorbable suture."