ZHealth News

November 2016 Q & A

Question: Cutting Angioplasty with Perforation

Under fluoroscopic guidance, the upper arm dialysis access fistula was catheterized and fistulogram was obtained. There was a greater than 50% stenosis within the mid cephalic vein that was dilated with an 8 mm angioplasty balloon and high pressure angioplasty balloon with no effect. The lesion was then dilated with a cutting balloon. Following angioplasty with a cutting balloon there was a leak identified from the cephalic vein. Multiple attempts at balloon tamponade were performed, and these were unsuccessful at controlling the leak. An 8 mm x 6 cm fluency stent graft was then placed across the leak and dilated to 8 mm. Follow-up fistulogram was obtained and showed free flow of contrast through the stent. Cephalic arch and central veins are patent. The arterial anastomosis is widely patent. There is a small pseudoaneurysm in the cephalic vein near the arterial anastomosis.
I am assigning codes 36147 and 37238. Should something be stated about the perforation? If so, how should this be coded?

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Posted in Free Newsletters By Sondra Dunn

ZHealth Coding Newsletter - July 2014

Jul 17, 2014 5:58:00 PM

July 2014 Q & A

Question: AV Fistula Arterial Angioplasty with Venous Stent

I was wondering what the coding protocol would be when we angioplasty the arterial anastomosis and place a stent in the graft venous outflow. Would one procedure override the other, as arterial angioplasty would be...

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Posted in Free Newsletters By Sondra Dunn

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