Part B Insider (Multispecialty) Coding Alert

Reader Question:

Arm Isn't Only Access Graft Location

Question: What is a code for a dialysis access graft placement in the leg? The procedure involves an arteriovenous fistula anastomosis done for dialysis, but I’m not sure which codes we can use in the leg.


Answer:
Although many arteriovenous anastomosis codes are specific for the arm (such as 36818-36820, Arteriovenous anastomosis, open …), not all are.


Several codes are available for any site. You should choose the proper code for the procedure based on the details documented in the op report. For instance, you might report one of the following codes:

  • 36821 — … direct, any site (e.g., Cimino type), (separate procedure)
  • 36825 — Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); autogenous graft
  • 36830 — … nonautogenous graft (e.g., biological collagen, thermoplastic graft).

Look for documentation in the operative report to guide you in choosing the proper code.

 

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