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36832
Date: Apr 2, 2012
Question:
I'm stuck on this one, any info. on your end would be greatly appreciated.
this pt. had 36819 (Arteriovenous anastomosis, open; by upper arm basilic vein transposition) done in November.
I'm not sure what this is exactly…36832-58??
PREOPERATIVE DIAGNOSES:
1. End-stage renal disease.
2. First-stage right brachiobasilic fistula.
POSTOPERATIVE DIAGNOSES:
1. End-stage renal disease.
2. First-stage right brachiobasilic fistula.
OPERATION PERFORMED: Second-stage superficialization of right brachiobasilic fistula.
ANESTHESIA: General endotracheal anesthesia.
ESTIMATED BLOOD LOSS: Less than 10 mL.
COMPLICATIONS: None apparent.
INDICATIONS: This 64-year-old male had failed autogenous access in the left upper extremity and had underwent a primary first-staged right brachiobasilic fistula in November 2011. He presents now for creation of a second-stage brachiobasilic fistula on the right to superficialize the fistula.
SPECIMEN: None.
FINDINGS: Patent right brachiobasilic fistula.
OPERATION: The patient was brought to the operating room and placed in a supine position. After a time-out was performed, the right upper extremity was prepped and draped in a sterile fashion. The brachiobasilic fistula was palpable with a thrill from the antecubital fossa up to the axilla. This was marked and an incision sharply created over the arteriovenous fistula. Any small additional side branches were divided between 3-0 and 2-0 silk ties. The fistula was then mobilized and brought more anteromedial in a superficial position. The subcutaneous tissues were then closed with running 3-0 Vicryl suture followed by 4-0 Monocryl and Dermabond. The patient remained with a palpable radial pulse and an excellent thrill in the superficialized fistula. I was present for the entire portion of procedure. The patient was extubated and transferred to the recovery area in stable condition.
this pt. had 36819 (Arteriovenous anastomosis, open; by upper arm basilic vein transposition) done in November.
I'm not sure what this is exactly…36832-58??
PREOPERATIVE DIAGNOSES:
1. End-stage renal disease.
2. First-stage right brachiobasilic fistula.
POSTOPERATIVE DIAGNOSES:
1. End-stage renal disease.
2. First-stage right brachiobasilic fistula.
OPERATION PERFORMED: Second-stage superficialization of right brachiobasilic fistula.
ANESTHESIA: General endotracheal anesthesia.
ESTIMATED BLOOD LOSS: Less than 10 mL.
COMPLICATIONS: None apparent.
INDICATIONS: This 64-year-old male had failed autogenous access in the left upper extremity and had underwent a primary first-staged right brachiobasilic fistula in November 2011. He presents now for creation of a second-stage brachiobasilic fistula on the right to superficialize the fistula.
SPECIMEN: None.
FINDINGS: Patent right brachiobasilic fistula.
OPERATION: The patient was brought to the operating room and placed in a supine position. After a time-out was performed, the right upper extremity was prepped and draped in a sterile fashion. The brachiobasilic fistula was palpable with a thrill from the antecubital fossa up to the axilla. This was marked and an incision sharply created over the arteriovenous fistula. Any small additional side branches were divided between 3-0 and 2-0 silk ties. The fistula was then mobilized and brought more anteromedial in a superficial position. The subcutaneous tissues were then closed with running 3-0 Vicryl suture followed by 4-0 Monocryl and Dermabond. The patient remained with a palpable radial pulse and an excellent thrill in the superficialized fistula. I was present for the entire portion of procedure. The patient was extubated and transferred to the recovery area in stable condition.
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