# superficialization of av fistula CPT?



## BwitchyCoder

obese patient needs av fistula brought closer to skin surface for use in dialysis...  any ideas?
Any input would be much appreciated


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## jaisheela

Hi,
It is commonly known that the best type of vascular access for chronic hemodialysis, defined as the one with the lowest number of complications and longest use, is the primary (Brescia-Cimino) radiocephalic fistula. One reason for the impossibility of its creation is that the vein vessel on the forearm is located too deeply, which is primarily caused by the patients' obesity.

Subcutaneous transposition of the arterialized median antebrachial vein is a simple and effective method of an adequate distal native fistula creation in patients with deeply located forearm veins.

The code 36825 is used  when a length of harvested vein from the patient is used as an autogenous graft and is sutured to the incisied artery and vein. 36830 is used if a nonautogenous graft , such as biological or a thermoplastic graft is used.

Hope this helps.

Thanks & regards,
Jaisheela CPC


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## neenlee

*Need help*

Hello-I just tried to use those codes-36825 and 36830 in a code-a-round note and was told they were wrong. Trying to finish my CEU's
Jeannine Hilb
CPC-A


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