# superficialization of av fistula CPT?-patient needs



## BwitchyCoder (Jul 21, 2008)

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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## thythaot (Jul 21, 2008)

*New*

Hi,

In your case, I am sorry that it is not enough information. But, with my thinking,  When a person's kidneys fail, dialysis is often required if transplantation cannot be performed. Dialysis can be performed using the abdominal cavity (peritoneal dialysis) or by filtering the blood. In turn, blood for filtration can be obtained via a catheter or arteriovenous fistula (AV fistula). Catheters can be placed on short notice but have a short usable life-span and are difficult to care for. By contrast, a fistula requires surgery and cannot be used until they heal, but can last for years. In this case, your physician perform AV fistula, but we have many type of fistula that your own veins and arteries and stay as far out on the arm as possible. 
In CPT, AV fistula code is 36831 - 36870. I don't know which detail that your physician perform to patient. You can choose in there. 
I hope it can get to your idea.


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## lisammy (Jul 30, 2008)

Are you talking about a transpostition?  That is when they allow a fistula to mature and then bring the pt back into the operation room and tunnel it closer to the top. Look at codes 36818-36819.  Hope this helps.


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## jlgwalt64 (May 16, 2011)

36818-36819 are not correct for the transposition superficialization, these codes are used for the initial AV fistula creation. The patient is then brought back a couple months later to have this vein 'superficialized'. I do not know if there is a code for this - looking for it myself.


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## churst21 (Sep 20, 2013)

I know this is 2 years late. But I normally use 36832-revision of av fistula


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## kae108 (Aug 25, 2015)

*Response 2 years late*

I read this and had to reply - I am glad you replied. It still helps us new to this who are still researching.


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