View attachment 5098CPT code 36821, Arteriovenous anastomosis, open; direct, any site (eg, Cimino type)(separate procedure), is used to report a direct anastomosis between an artery and a vein to create a direct autogenous hemodialysis access. This procedure does not require multiple incisions, transposition of the vein, or creation of a tunnel.
Usually, the clinical indication is ESRD.This looks like a homework assignment. If you aren't understanding the op note terminology, just filling a blank with a CPT code will do you no good in the long run.
These exercises are an example of what a coder will be expected to understand at a real job so you're best option is to work through the example until you can match it with a code.
Sometimes it can help if you use a highlighter to mark the important points in this scenario and be sure you know what the abbreviations stand for, like HD (hemodialysis), LUE (Left Upper Extremity), and AVF (Arterio-venous Fistula). That last one is a biggy! This whole narrative centers around the creation of creating a direct connection between an artery and vein. Now I have a question for you: why do they need this connection in the first place? I'm really interested in discussing this with You so please don't respond to this unless you are suchang78 but stay tuned if the subject interests you!