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AVF Thrombectomy/Revision with PTA/Stent of the newly created anastomosis

Date: Apr 18, 2016

Question:

I have a question regarding a thrombectomy/revision of a brachiocephalic AVF followed by PTA/stenting of the newly created anastomosis. "The surgeon performed a fistulogram, revealing occlusion/thrombus of the cephalic vein. He then removes the thrombus. Further occlusion was found near the shoulder. Incision was extended to dissect out more of the cephalic vein. A second incision was made in the axilla, and the basilic vein was dissected out. The basilic vein was then anastomosed to the cephalic vein. Another fistulogram was performed, revealing stenosis in the area of the end-to-end anastomosis. The surgeon then angioplastied and stented this." Would the correct coding for this be 36833 (thrombectomy/revision) and 36147 (fistulogram) only? I do not believe that I should code for the stenting (37238) due to it being done at the anastomosis just created. I was looking at it as an inflow/outflow type issue. Am I correct in my thinking?

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