I am new at coding AV fistula's and here is some key points of the op note.
Preop Diagnosis:
1. Stenosis and occlusion of right radiocephalic arteriovenous fistula.
2. End-stage renal disease.
Postop Diagnosis:
1. Stenosis and occlusion of right radiocephalic arteriovenous fistula.
2. End-stage renal disease.
Operation: Revision right radiocephalic arteriovenous fistula with reveresed interposition sapheous vein graft harvested from right thigh.
Operative report:
The patients right arm was prepared and draped in usual sterile fashion as was the thigh. A longitudinal incision was made overlying the cephalic vein at the wrist. Multiple small side branches emanating from this were ligated with 3-0 silk ties. The cephalic vein was mobilized at the antecubital fossa through a longitudinal incision as well. It was encircled with vessel loops. Sapheous vein was harvested from the right thigh from saphenofemoral junction to the proximal third of the thigh, and the diameter of the saphenous vein here was 6 mm. The interval segment was harvested between 2-0 silk ties. It was distended with hepariinized saline. It was placed in reverse fashion and sewn end - to- end to the cephalic vein at the wrist with a spatulated anastomosis using 6-0 polypropylene running suture. It was then tunneled subcutaneously to the cephalic vein at the antecubital fossa where it was sewn end to end with a spatulated anastomosis using 6-0 polypropylene running suture. Excellent thrill within the fistula at completion.
The doctor coded 36832. Do you also code the saphenous vein graft harvest?
Preop Diagnosis:
1. Stenosis and occlusion of right radiocephalic arteriovenous fistula.
2. End-stage renal disease.
Postop Diagnosis:
1. Stenosis and occlusion of right radiocephalic arteriovenous fistula.
2. End-stage renal disease.
Operation: Revision right radiocephalic arteriovenous fistula with reveresed interposition sapheous vein graft harvested from right thigh.
Operative report:
The patients right arm was prepared and draped in usual sterile fashion as was the thigh. A longitudinal incision was made overlying the cephalic vein at the wrist. Multiple small side branches emanating from this were ligated with 3-0 silk ties. The cephalic vein was mobilized at the antecubital fossa through a longitudinal incision as well. It was encircled with vessel loops. Sapheous vein was harvested from the right thigh from saphenofemoral junction to the proximal third of the thigh, and the diameter of the saphenous vein here was 6 mm. The interval segment was harvested between 2-0 silk ties. It was distended with hepariinized saline. It was placed in reverse fashion and sewn end - to- end to the cephalic vein at the wrist with a spatulated anastomosis using 6-0 polypropylene running suture. It was then tunneled subcutaneously to the cephalic vein at the antecubital fossa where it was sewn end to end with a spatulated anastomosis using 6-0 polypropylene running suture. Excellent thrill within the fistula at completion.
The doctor coded 36832. Do you also code the saphenous vein graft harvest?
