Cardiology Coding Alert

Question: The physician is reporting repair of left arm dialysis AV graft with percutaneous transluminal deployment of two covered stent grafts for two focal pseudoaneurysms with operative fistulogram. Which codes should I use for a Medicare patient?

Codify Member

Answer: You should report stent placement using 37205 (Transcatheter placement of an intravascular stent[s] [except coronary, carotid, vertebral, iliac, and lower extremity arteries], percutaneous; initial vessel). Both stents are in a single vessel, the arteriovenous (AV) graft, so you should report only one unit of 37205, which applies to all stents in the "initial vessel."

Code 36147 (Introduction of needle and/or catheter, arteriovenous shunt created for dialysis [graft/fistula]; initial access with complete radiological evaluation of dialysis access, including fluoroscopy, image documentation and report [includes access of shunt, injection(s) of contrast, and all necessary imaging from the arterial anastomosis and adjacent artery through entire venous outflow including the inferior or superior vena cava]) describes fistulogram of a dialysis AV graft.

For the stenting radiological supervision and interpretation, you should report 75960-26 (Transcatheter introduction of intravascular stent[s] [except coronary, carotid, vertebral, iliac, and lower extremity artery], percutaneous and/or open, radiological supervision and interpretation, each vessel; Professional component). Again, you should report only a single unit because the code applies to "each vessel."