Wiki Ligation branch with fistula creation via 2 different incisions

[such78]

May I have advice for below case?

Procedures:
1. Hemodialysis access, autogenous fistula, branchiocephalic, left antercubital crease
2. Ligation of large accessory branch via small separate incision, left extremity.


The surgeon performed creation of arteriovenous fistula . Also performed closure commenced after making a small separate stab incision, closing an obviously large and a clearly visible cutaneous tributary.

is 36821 ( arteriovenous creation) included ligation (37607) when both are done at the same encounter? Or code both separately?

Thank you in advance.

 

[cpc2007]

The ligation is included when both are done at the same encounter. Even if they have to create a separate incision to ligate tributaries or collateral vessels that could compromise the flow in the new AV fistula, it is considered part of the 36821 because they have to take the steps necessary to ensure adequate flow in the fistula.

I hope that helps

Kim
www.codingmastery.com

 

[such78]

The ligation is included when both are done at the same encounter. Even if they have to create a separate incision to ligate tributaries or collateral vessels that could compromise the flow in the new AV fistula, it is considered part of the 36821 because they have to take the steps necessary to ensure adequate flow in the fistula.

I hope that helps

Kim
www.codingmastery.com

Thank you.