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Codes 36901-36908 describe procedures performed through a direct percutaneous access or a puncture of the dialysis circuit. These codes include all accesses; catheter movements within the circuit; contrast injections; imaging for diagnosis, guidance, and follow-up S&I of the circuit; and access closure. Conscious sedation (99151-99153, 99155-99157) and ultrasound guidance for vascular access (76937) are separately billable (however, code 76937 is only reported when the AV graft or fistula is documented as either immature or failing). If the provider states in the OR report pre/post of diagnosis of dysfunctional AV fistula; is that enough to support it is failing? All other doc requirements for 76937 have been met (selected vessel patency/permanent image on file).