# Revision Closure of AV Graft



## AB87 (Apr 9, 2014)

Im trying to find a CPT Code for a Closure of a AV Graft (Open Procedure) (due to Severe Steal Syndrome). The doctor closed the upper extremity Graft with Sutures and then made a New AV graft for the Lower extremity.

For the Upper Extremity could i use vessel repair codes (35201-35286) 

Thank You Very Much In Advance


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## jkayser (Apr 15, 2014)

Please see if this question/answer information is appropriate to your situation.  The locations of the old versus the new AVF are different from your case but the principle would be the same with the ligation of the old and the creation of the new.  

http://www.asdin.org/general/custom.asp?page=217

(4/4/12)
" Q:  Having trouble coding the following scenario: 
Patient with a thrombosed radiocephalic AV fistula.  The fistula was ligated within several centimeters of the AV anastomosis.  The aneurysmal segment was then excised, and the vein was ligated proximally.  A brachial to brachial vein AV fistula was then created.
 Is this coded as a ligation of the radiocephalic AV fistula (CPT 37607) and creation of a new AV fistula (CPT 36821)?
 A:  In my view that would be the appropriate coding for the case with the appropriate -59 modifier
 The radial;-cephalic fistula was ligated -- 1 procedure
 A brachial-brachial fistula was created ? 2nd procedure
 Since these are in separate anatomical areas, I would interpret as separate procedures"

I hope this is helpful and can be applied to your case.

Jean Kayser CPC CIRCC


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## AB87 (Apr 17, 2014)

Thank You! This Helps out a lot!


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