Ask Dr. Z

Our physicians are performing this procedure more often to elevate a fistula. "Preoperative ultrasound was used to interrogate the AV access which identified significant depth between the dermis and cannulation zone with depth of 15 mm. Standard wetting solution consisting of saline lidocaine and epinephrine mixture was infiltrated into the subcutaneous tissue space using tumescent technique immediately surrounding and superficial to the AV access. Suction lipectomy was performed in the subcutaneous tissue layer directly superficial to the AV access for the entire cannulation zone under direct visualization of ultrasound to achieve desired tissue depth for appropriate future cannulation. Final depth visualized by US was 3 mm. Post suction lipectomy access angiogram demonstrated no injuries." I reviewed Question ID 4005 from 2012 and wondered if your recommendation is still the same. Physician would like to report 36832 only for this service. Thanks in advance - you all are the best!