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Wiki Z99.2 in CKD Stage V patients

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Virginia Gardens, FL
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Hi!,

Recently came across some insurance rejections for the use of code Z99.2 along with N18.5, the documentation clearly states that the patient is with a fistula preparing to start renal dialysis in the upcoming weeks. Is it possible to use both codes?? especially since the description for Z99.2 includes:

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Presence of arteriovenous shunt for dialysis
 
Hi Osvald
Did you put N18.5 as first dx then Z99 last dx code? But you say the dialysis has not started yet? It seems an AV fistula is a connection that’s made between an artery and a vein for dialysis access. A surgical procedure, done in the operating room, is required to stitch together two vessels to create an AV fistula. The access point must be durable enough to withstand dialysis treatment several times a week without collapsing. So billing both together and fistula may have cause your denial.
Lady T
 
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