Ask Dr. Z

What CPT code is appropriate for the following example? "The larger of the two aneurysms was the venous cannulation site. Micropuncture kit was used to cannulate the fistula, which appeared to be brachiocephalic. Fistulogram was performed, which turned down to the axilla rather than showing the usual cephalic vein outflow. Glidewire was advanced with a Dorado balloon parked across the stenosis of about 85%; it was inflated at 10 atmosphere. Fistulogram showed improvement of stenosis. The catheter was then removed, and the hole in the fistula was closed with a clamp. A clamp was applied across the inflow of the fistula. The aneurysm was squeezed to remove most of the blood in it, and then the outflow was clamped as well. A longitudinal incision was made on the anterolateral aspect of the fistula, and a large amount of excess fistula wall was excised. The lumen was irrigated with heparinized saline, and the fistulotomy was closed longitudinally using running 5-0 Prolene. Flow was restored."