Wiki AV fistula-use of second puncture code 36148

[greeneis50]

We have had some discussion about the correct use of the add-on code for the second puncture of the AV fistula 36148, the description in CPT additional access for therapeutic intervention. Would you use 36148 in addition to 36147 for the second puncture if no therapy was performed? We were wondering if anyone has information to clarify this and if so, is it documented somewhere that we can access? Thanks in advance for any assistance!

 

[BLOWRIE]

The CPT text with green bullet states "If 36147 indicates the need for a therapeutic intervention requiring a second catheterization of the shunt, use 36148". Do you have a situation in which you need to access the shunt for any other reason than therapeutic intervention. Code 36147 indicates it is the only code necessary to determine the necessary imaging of the Arteriovenous Shunt. I would be interested in hearing your input as to what other instances you would use the add on code , 36148. Thanks