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AVG Failure, AVF creation with same vein
Question:
"Patient has failed AVG in the forearm and presents for new AVF. The cephalic vein was identified, which had been part of the previous graft. The graft was dissected, and the segment connected to the cephalic vein was excised. The lateral branch of the cephalic vein through which the graft was connected was remodeled and oversewn with stitches. Brachial artery and cephalic vein were used to create the new AVF. Only the cephalic end of the AVG was removed."
Would this be considered a revision or removal with modifier -52 and new AVF code? (Brachial artery not used in the original AVG)
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