Ask Dr. Z

What advice can you offer for this encounter? Patient was originally scheduled for an AV shunt imaging for maturation. Only an US scan ended up being performed. "US exam of the left upper extremity in the area of the surgically created fistula was performed. A patent radial artery was identified. The anastomosis was identified, however, no flow was noted within the outflow vein. A segment of approximately 1 1/2 to 2 cm of the juxta anastomotic vein was thrombosed/occluded. There is reconstitution of the outflow vein via collaterals. Given that the juxta anastomotic outflow vein was very small and already occluded no intervention was done at this time." Since no attempt at access was performed, I don't think it is appropriate to report an aborted 36901. This is an extremity, but 76882 doesn't seem appropriate since this is vascular. Not a Duplex study. This doesn't seem to fit 93922. Thank you for your help.