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Is the following documentation enough to bill for 76937 during an AV fistulogram and Angioplasty of the venous arm of the graft. And also would we need a 59 modifier on this procedure. Under ultrasound guidance, a 21-gauge micropuncture needle was used to access the graft near the arterial anastomosis but central to the aneurysmal segment. The documentation then goes on to discribe the AV Fistulogram part of the procedure. Another question on IV acess. My understanding is that it is not acceptable to code multiple unsucessful attempts at iv access is this correct.