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Fistulogram coding

  1. Default Fistulogram coding
    Medical Coding Books
    Need some help with CPT coding for a fistulogram. Also, physician did angioplasty of axillary veins. Would it be correct to use 35476.

    Appreciate any advice.

    Thanks. Vicky

  2. Default
    We use 75790-26 for the fistulagrams, but you need to read the op note and make sure it was in the fistula itself and not the vein, in which case 75820-26 would be appropriate. As for the angioplasty, that is the correct code if it is done percutaneous. You would also use 36870 for the declot and 36145 for the introduction of the cath percutaneous. But if they made and incision and all this is done open, we use 36833, 35460-51 and 75978-26. Hope this helps.

  3. #3
    Default
    don't forget the G-codes for an angioplasty of the fistula

  4. Default
    We do angios of fistulas all the time. I wasn't aware there were G codes for this. When would I need to use them instead of the CPT codes?

  5. Default
    G0392 Transluminal balloon angioplasty, percutaneous; for maintenance of hemodialysis access, arteriovenous fistula or graft; arterial

    G0393 Transluminal balloon angioplasty, percutaneous; for maintenance of hemodialysis access, arteriovenous fistula or graft; venous

    If angioplasty done in graft use these codes.

    Be sure to code the catheterization of the limbs in addition to therapeutic procedures. If both the arterial and venous sides are both punctured, 36145 would be reported twice. You may need modifier –59 with this. It is also called “fistulogram.”
    Report S&I code 75790 for imaging

    Code S&I 75790 includes imaging of outflow to the level of the right atrium. Do not report the 75825 vena cavagram S&I and 75820 extremity code with this. It is included.
    Angioplasty of AV fistula use 35476 + 75978 or G0393 + 75978 for Venous PTA of AV graft Medicare or G0392 + 75962 for Arterial only PTA for of AV graft Medicare .

    Zones for AV Graft/Upper

    Upper Extremity

    Zone 1: Arterial anastomosis, intra-graft, venous anastomosis and outflow veins to axillary vein
    Zone 2: Subclavian and brachiocephalic veins (central extremity veins)
    Zone 3: Superior Vena Cava
    Only one venoplasty per zone

    can be reported in this

    Interpretation.

    Zones for Lower Extremity

    Lower Extremity

    Zone 1: Arterial anastomosis, intra-graft to venous anastomosis (common femoral vein)
    Zone 2: External iliac and common iliac veins (central extremity veins)
    Zone 3: Inferior Vena Cava
    Only one venoplasty per zone can be reported
    Last edited by Shirleybala; 04-07-2009 at 10:10 PM.

  6. Default
    Thank you so much. Very helpful.

    Vicky

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