Resection of aneurysmal AV fistula

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 The coding advice may or may not be outdated.


"We proceeded to dissect down to the brachial anastomosis. We used the same 1.5 cm incision that was placed originally. We dissected down to the aneurysmal portion of the anastomotic region, and the brachial artery was sharply dissected free in addition to the proximal end of the vein, proximally and distally. We transected the venous outflow off the arterial end. We left the cuff and over-sewed. We turned our attention to the venous portions of the vein graft, which is causing symptoms. We incised over the aneurysmal portions and created flaps around the vein since it was fairly superficialized to the skin for multiple areas. There was a thin plane in which we maintained all compromising skin. We dissected down the flaps to create the flaps circumferentially, and the vein was mobilized towards the distal anastomosis. We dissected this free and sharply ligated with sutures. We then removed all the aneurysmal venous portions en bloc." Code 36832 doesn't apply since AV was removed. CPT 37607 or 35011?

Question ID: 9438
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