Wiki Fistulogram, balloon angioplasty LT subclavian in-stenos

nlbarnes

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36902 or 37246?

PROCEDURE:
Using ultrasound guidance, the
outflow vein was cannulated away from the anastomosis of the fistula.
Using a micro wire and dilator introducer kit, the outflow vein was
cannulated and upsized to an 0.035 wire. A picture was taken with the
ultrasound and sent off into the chart. A J-wire was placed centrally
and the micro wire dilator introducer sheath was exchanged for a short
6-French sheath. Through this, a fistulogram was obtained, which
demonstrated no outflow stenosis in the cephalic vein but, however,
more centrally, the collateral pattern suggested a stenosis at the
proximal region of the subclavian stent. Therefore, this lesion was
crossed and balloon angioplastied over a stiff wire using a 10 mm
balloon. Completion demonstrated improved flow dynamics, which
suggested that there was some short-segment stenosis or web, which had
been treated. All wires and sheaths were removed. Pressure was held
for 25 minutes and the dressing was hemostatic at the completion.

600214884
 
Interventional Technologist

Sounds like just 36901+36907.
 
Last edited:
The correct coding is 36901 and 36907. 36907 because the subclavian is in the "central dialysis" segment.

Thanks,
 
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