Ask Dr. Z

How would an AV fistula case be coded with initial fistulogram (36147) performed from fistula? But to treat the arterial stenosis access was obtained via the left IJ, catheter advanced to left subclavian, and then glidewire was used to access the fistula retrograde and catheter brought across the arterial anastomosis. The arterial anastomosis and juxta arterial outflow were treated with angioplasty along with the remainder of the venous outflow. The graft is only described as a left UE bovine graft. I am stumped on coding for the retrograde access from the IJ approach and would appreciate your guidance.