Ask Dr. Z

Your 2023 Interventional Radiology Coding reference under Dialysis circuit intervention #10 advises “When imaging of the dialysis circuit is performed from a remote access (not via direct access of the circuit), use code 36901-52 (or -74 for hospital billing) as well as the remote arterial access catheter placement code (e.g., 36217 for right brachial artery injection of fistula when access is via the common femoral artery).” Based on recent advice in HCPCS Coding Clinic, they indicate modifier 74 should not be used if the intended px is performed. Your facility coding advice to use -74 doesn’t appear correct. However, uncertain if an unlisted code would be used or code i.e. 36901 with no modifier. What code would you assign if a cephalic vein fistula is accessed via the right internal jugular and fistulogram performed?