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Ligation and Embolization of separate collateral veins

Date: Jan 15, 2021

Question:

"Access was gained in both directions. Multiple injections of intravenous contrast were given, and a fistulogram was performed and evaluated. Arterial anastomosis and JA segment stenosis occluding more than 80% of the flow. 6 mm balloon angioplasty was performed. The flow was sluggish. Therefore, a catheter was introduced into the upstream radial artery than 10 cm away from the arterial anastomosis. Digital subtraction imaging revealed patent upstream and downstream radial artery with sluggish flow into the fistula. The more inferior collateral vessel was smaller and more tortuous. This vessel was then coil embolized. Follow-up imaging shows cessation of flow through this collateral vessel. The larger collateral vessel within the arterial limb of the fistula had more laminar and direct flow to the more central circulation and therefore required ligation. The skin anesthetized with lidocaine, and a 1 to 2 cm incision was made overlying this collateral vessel. The vessel was bluntly dissected/ligated." Can 36832, 36909, 36215, 75710 be coded?

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