Ask Dr. Z

Dr Z, The patient came in and had a diagnostic fistulogram performed showing severe calcification/stenosis in arterial side along with formation of thrombus. The MD performed an arterial PTA and then opened the graft and removed thrombus. A follow-up fistulogram was done but complete occlusion was noted in the cephalic vein and attempts to cannulate were unsuccessful. The MD decided that this fistula was beyond repair and performed a ligation. A temporary dialysis catheter was placed. Since the PTA was through a separate access, I was thinking 35475/75962. However, I am not sure how to capture both the thrombectomy and ligation - since the fistula is no longer functional. Any assistance would be appreciated. Thanks.