# Ligation of AV Fistula



## dpumford (Feb 11, 2011)

Hi!  If a physicians does a Branch ligation arteriovenous fistula, rt foream x2.  Can it be billed as 37607, 37607-59?

Ligation was done on two different branches and two separate incisions were done. Short incisions perpendicular to the long axis of the vein were made.  The vein was identified circumferentially mobilzied and ligated with fine silk tie.  This was done on two different branches.

I believe since it was done on the same fistula you can only bill it once.  He thinks it should be twice since two incisions were done.  

I can not find anything in writing  so any advice is appreciated!


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## lisammy (Feb 14, 2011)

If you are going to use 37607 then I aggree you can only use it once per fistula.  Talk it over with your surgeon though because sometimes when they are ligating brances billing a revision(36832) is more approprite, because you are not changing the size or flow in the actual fistula.
Hope this helps.


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## dpumford (Feb 17, 2011)

*Ligation Av fistula*

: Thank yo so much for responding...Revision may be the way to go.. Thanks~


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