Ask Dr. Z

"A 5 x 40 mm Bard conquest balloon was then positioned across the arterial anastomosis and the proximal fistulous inflow and a prolonged and insufflation performed with balloon achieving profile. Kumpe catheters repositioned in the brachial artery angiography performed. 1.5 cm cleaner device was passed from the distal sheath and attempt to break up thrombus within the aneurysmal segment of the cannulation zones fistula without success. This appeared to be very mature thrombus. Despite further attempts at balloon angioplasty and balloon maceration never achieved beyond temporary patency with residual thrombus occlusive in nature unable to be removed. Selective left upper extremity angiography was performed via the fistula using Kumpe catheter positioned in the brachial artery proximal to the anastomosis. Serial dynamic imaging obtained from this location distally to the fingertips."

They want to bill 36905, but I would like your opinion of the failed thrombectomy.