Wiki Av graft and radial arterythrombectomy

[MADDIE]

Hi, looking for input regarding the following thrombectomy of an AV graft.

Fistulogram
Mechanical thrombolysis of Brachial axillary AV graft
Embolectomy of arterial anastomois
Angioplasty and stent of AV graft

The operative note documents all of the above but it also states that the inflow was sluggish so a wire and catheter were redirected towards the hand into the radial artery and all thrombus was brought back into the previous placed 6- French sheath. The French-6 sheath was then suctioned and this showed fresh thrombi. This was repeated 2x.
Codes 37147, 36870, 37236
Should I then code 36215 and 37184 for the above as the radial artery is outside of the brachial artery graft?

 

[dpeoples]

Hi, looking for input regarding the following thrombectomy of an AV graft.

Fistulogram
Mechanical thrombolysis of Brachial axillary AV graft
Embolectomy of arterial anastomois
Angioplasty and stent of AV graft

The operative note documents all of the above but it also states that the inflow was sluggish so a wire and catheter were redirected towards the hand into the radial artery and all thrombus was brought back into the previous placed 6- French sheath. The French-6 sheath was then suctioned and this showed fresh thrombi. This was repeated 2x.
Codes 37147, 36870, 37236
Should I then code 36215 and 37184 for the above as the radial artery is outside of the brachial artery graft?

Where was the initial access? If it was the radial artery, then 36215 does not apply. You may have a 37184 but could have trouble getting reimbursed without a modifer (59) and or submitting documentation.

HTH