Cardiology Coding Alert

Question: For a patient with end stage renal disease, what is the appropriate ICD-10 code for thrombosis of AV dialysis fistula?

Oregon Subscriber

Answer: You should report T82.868A (Thrombosis due to vascular prosthetic devices, implants and grafts, initial encounter) at the initial encounter for a malfunctioning dialysis shunt.

Watch for: Code T82.- (Complications of cardiac and vascular prosthetic devices, implants and grafts) has an Excludes2 note for failure and rejection of transplanted organs and tissue (T86.-).

Some payers may want you to add a code for the chronic renal failure, as well. For a patient with end stage renal disease, you’d use N18.6 (End stage renal disease).

Definitions: Thrombosis is a blood clot. There are two main types: Venous (a clot blocking a vein) and arterial (a clot blocking an artery). The AV (arteriovenous) fistula is a surgically created connection between an artery and a vein to expedite chronic (long-term) hemodialysis — a kind of dialysis.