Ask Dr. Z

We have a patient who had an ulcerated left AVF. We ligated the fistula, and she had further issues with the wound healing after the ligation surgery. She came in for her new access in the right arm and had foul smelling drainage from the open wound in the left arm. Decision was made to debride the wound and excise the portion of the AVF that contained the infected hematoma and to create the new AVF in the right arm. We did the AVF creation in the right upper extremity. My concern is how to code the excision/debridement. This was an AVF, not graft, so I don’t feel as though code 35903 would be accurate. I also don’t feel as though a debridement code or 10180 would cover the amount of work actually done. I don’t think I like a revision code either, because they don’t intend on using the AVF. I would appreciate your input!