Ask Dr. Z

Greetings, This patient has a AV graft. The physician does a open thrombectomy of the arterial and venous sides of the graft. Following this a AV shuntogram is performed. This shows irregular calcifications in the graft. A curettage of the graft was performed to remove calcifications. Follow up angio showed a stenosis at the venous anastomosis which is ballon angioplastied. Due to pt history of strictureplasty a stent was placed. I think I can code 36831-59 thrombectomy / the shuntogram with code 75791-26-59/ Angioplasty is bundled with the stent placement / Stent codes 37207, 75960-26. What about the curettage? I'm not sure about the curettage. Would I code this as a 36833 and think of the curetage as a revision with thrombectomy along with code 75791-26-59 and then the angioplasy and stent are bundled as they are completed in the same zone as the revision. Any clarification would help. Thanks, LW