Wiki Ligation branch with fistula creation

[such78]

May I have advice for below case?

Procedures:
1. Hemodialysis access, autogenous fistula, branchiocephalic, left antercubital crease
2. Ligation of large accessory branch via small separate incision, left extremity.


The surgeon performed creation of arteriovenous fistula . Also performed closure commenced after making a small separate stab incision, closing an obviously large and a clearly visible cutaneous tributary.

is 36821 ( arteriovenous creation) included ligation (37607) when both are done at the same encounter? Or code both separately?

Thank you in advance.

 

[cbutsko]

I would code it as 36821, 37607-51. Per NCCI edits you can bill both, AND the surgeon specified that he used a separate incision for the 37607. That makes them both able to be billed with just a modifier 51 on the 37607 to indicate multiple procedures.

 

[such78]

I would code it as 36821, 37607-51. Per NCCI edits you can bill both, AND the surgeon specified that he used a separate incision for the 37607. That makes them both able to be billed with just a modifier 51 on the 37607 to indicate multiple procedures.

Thank you.