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Excision of Aneurysm of Nonusable AV Fistula

Date: Jul 28, 2021

Question:

Patient with an aneurysm of non-functioning fistula that hasn't been used since 2018 due to clotting. Procedure was coded as 37799, but insurance is denying. Is this the correct coding, and if so, is there any suggested information that can be sent to help fight this claim?

"Longitudinal elliptical incision around the existing aneurysm down to the level of the elbow was made. I identified the brachial artery in the AV fistula aneurysmal anastomosis. I clamped just above the anastomosis on the fistula after dissecting around it to get complete control. After complete proximal control I extended the elliptical incision around the entire aneurysmal portion of the fistula. Using electrocautery I dissected the entire aneurysmal dilated fistula out all the way to the occluded area in the mid upper arm. I ligated this off with a silk tie and then excised the aneurysm in its entirety. I tied off the fistula just above the anastomosis with a 5-0 Prolene suture in a running horizontal mattress fashion followed by running locking outer layer."

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