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a/v fistula

  1. #1
    Default a/v fistula
    Medical Coding Books
    I'm new at this....can't find the correct procedure code....please read procedure note below (58 y/o Medicare A/B)....thanx for any input/insight

    Pre-procedure Diagnoses

    Post-procedure Diagnoses


    Procedure: Left upper arm a/v fistula declotting.
    Radiologist: MD
    Findings: There is a thrombosed left upper arm a/v fistula. Attempt at declotting the fistula with 3mg of TPA and Teratola device was unsuccessful due to large clot burden. There were severe moderate stenosis of the fistula between the aneurysm treated with 8mm balloon dilatation. There is a severe stenosis to the draining cephalic vein in the chest just prior to the subclavian vein, however a wire pass with ease centrally. This was not treated yet for fear of Pulmonary embolism. A 10 cm infusion catheter was placed across the thrombosed fistula with urokinase infusion initiated at 30ml/hour ( 60,000 units/ hour.) Patient was started on heparin at 1000 units and hour.

    Plan: Follow up urokinase thrombolysis in AM with possible angioplasty of central cephalic stenosis with successful.
    Last edited by racheleporter; 04-21-2008 at 08:46 AM. Reason: take out md name
    Rachele Porter, AS, CPC, CPC-H, CEDC
    no weapons formed against me shall prosper

  2. Smile
    Hello, You may want to check out procedure code 37201 and S & I code
    75896-26. This is used for Urokinases other than coronary. You can also code for the catheter placement.

    You may also code 75898-26 Angio thru and existing catherter for follow-up study for transcatheter therapy.

    There is a percutaneous AV thrombectomy, mechanical thrombus extraction code 36870 that you should also review.

    Hope this points you in the right direction.

  3. Default
    Last edited by vikas.maheshwari; 02-17-2009 at 05:24 AM.

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