Ask Dr. Z

I would appreciate some coding assistance. "Indication: Patient is a 61-year-old male with a successful kidney transplant who wants his AV fistula removed because of persistent pain. The area of the fistula was infiltrated with local anesthetic, and the skin was incised sharply. The dissection was carried down using electrocautery and sharp dissection until the level of the graft. The graft was dissected freely from the surrounding tissues from the level of the arterial anastomosis in the antecubital fossa to the level of the connection between the vein and the axillary vein at the level of the shoulder. The graft was then transected, and the proximal portion was tied with a silk suture. The distal portion was oversewn with a 5-0 prolene. It was removed and handed off the operation field. After hemostasis was achieved, the wounds were irrigated and then closed." How would you code this? I'm thinking it's got to be unlisted. The physician verified this was a large AV fistula that was excised, not a graft.