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Wiki fistula question

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conniff

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Saint Louis Park, MN
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Hi coders!
I have a general question regarding the cpt code range 36818 to 36821.

If the doc accesses the cephalic vein and anastomosis to the brachial artery,
would you consider that as a direct anastomisis as in cpt 36821?? or would you go with cpt 36818 because of mention of cephalic vein??
....no mention of tunnelling, or moving the vein in report. Just exposure of both vessels and the anastamosis to the artery. thanks
 
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