There are new CPT codes for AV fistula coding in 2017. The old codes for AV fistula has been deleted. The new CPT codes of 2017 will be bundled codes and include all the minor procedure used for performing interventional procedure on AV. Arteriovenous (AV) shunt or fistula are created for vascular access sites which is required for hemodialysis. The AV fistula are direct artery to vein anastomosis and in AV grafts a prosthetic material is used a loop or connection to an artery (proximally) and vein (distally). AV fistula can be placed in upper arm or forearm, thigh or chest. So, the new CPT code 36901 is the main procedure code, used for taking access in AV fistula. Also, there are new procedure codes for spinal injection and angioplasty of arteries and vein of upper extremity in 2017. We will learn about these codes one by one. First check out more about CPT code 36901.
Description of CPT code 36901
The CPT code description of 39601 includes all the minor procedures. This code includes all the contrast injection, Radiological Supervision and Interpretation (RS&I) used while taking access or direct puncture in the AV fistula. Below is the detail description of CPT code 36901.
36901– Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous outflow including the inferior or superior vena cava, fluoroscopic guidance, radiological supervision and interpretation and image documentation and report
Now, as per the description CPT code 36901 includes all the contrast injection, RS&I and imaging of the entire dialysis circuit, including the adjacent inflow artery (peri-anastomotic region), arterial anastomosis, shunt, and venous outflow up to and including the complete superior or inferior vena cava. The CPT code 75791 (deleted in 2017) which used to describe the radiological supervision and interpretation only for a complete evaluation of an arteriovenous dialysis fistula or graft, will no more exist in 2017.
When to code CPT code 36901
For the initial access in AV fistula or graft or the direct puncture, CPT code 36901 should be used.
Do not report CPT code 36901 more than once for access and evaluation of an AV graft or shunt.
For a single or multiple access into the shunt, code 36901 should be reported once only to describe the access and imaging for the diagnostic study.
All the Additional access without intervention in AV fistula are included in CPT code 36901.
Earlier we used CPT code 36148 (deleted in 2017) for addition access in AV fistula with intervention. But, in 2017 all the additional access in AV fistula with intervention like angioplasty, stent etc. will be reported with CPT code 36902-36909.
When only the diagnostic angiography of the fistula or dialysis circuit is performed via a remote or existing access, we have to use 52 modifier along with CPT code 36901. For hospital billing we will use 74 modifier with 36901.
We need to report separately the selective catheter placement CPT codes when imaging is performed through remote access.
All the access sites into the AV fistula or graft for diagnostic shuntogram and/or intervention are bundled with codes 36901-36909.
Report CPT code 36120 for direct brachial artery puncture for the evaluation of AV fistula.