balloon dilation after thrombectomy for slight deformity? 36905/36904

Please note this question was answered in 2017. The coding advice may or may not be outdated.


I believe the correct code should be 36904 for the thrombectomy; however, the physician wants to charge for the angioplasty as well-36905. "The right forearm was prepped and draped in the usual sterile fashion.  A 19 gauge butterfly needle was introduced into the fistula and diagnostic venography was performed. 6-French vascular sheaths were placed with ultrasound guidance at the apex of the graft. Two sheaths were placed. One oriented toward the arterial side in the second sheath oriented toward the venous anastomosis. A 6 mm balloon catheter was used to fragment the thrombus on the venous side of the graft. The same balloon was used to remove the plug from the arterial anastomosis and it was pulled into the graft. The thrombus was then fragmented. Vigorous flushing of the graft was performed with saline. This resulted in restored flow through the graft. No residual thrombus present after completion of the thrombectomy. There is slight deformity of the arterial anastomosis. This was then dilated with a 7 mm balloon. There was good flow through the graft."

Question ID: 9298
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