Ask Dr. Z

Can I report codes 36831 and 36907 as well as direct repair of aneurysm if provider amends to which artery?

"We confirmed it almost completely thrombosed. We identified both anastomosis as well as area non aneurysmal areas where we can obtain control. We then made small transverse incision over AVF in medial arm just distal to arterial anastomosis and obtained circumferential control. We did the same just proximal to venous anastomosis. Patient was heparinized. We then made longitudinal fistulotomy over both aneurysms. We encountered large amount of occlusive thrombus and removed it. We used Fogarty catheter (# 4) to remove additional thrombus from venous segment. Next, we placed 11 French sheath into distal AVF and performed fistulogram. We identified stenosis at venous anastomosis and treated it with POBA (6, 8, and 10 mm). We performed central venogram and identified moderate stenosis in SCV that we treated with POBA (8 and 10 mm). We then performed aneurysmorrhaphy (excised redundant tissue and primary repair w 4-0 Prolene running suture). We then excised redundant thin skin as well."