Excision of brachiocephalic av fistula

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How would I code the attached report? I've had other coder input but one says to code this 36832 if they removed the entire fistula and another says to code 35266 for the artery repair.

I could use some guidance on these as I've started getting more and more of this type report.

Thanks and have a great day.
 

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  • EXCISION OF BRACHIOCEPHALIC AV FILTULA.pdf
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cpc2007

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I can only see the first page of the operative report (not sure if anything significant is on the second page beyond the patch repair of the brachial artery). To me, this reads as a fistula revision (I am interpreting that the physician resected an aneurysmal portion of the fistula and repaired the artery in the area where this aneurysm was resected but that the fistula is still intact at the end of the case). This would support CPT 36832. The repair of the artery is inclusive to the revision code and would not be separately reportable.

I hope that helps!
 
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