The arteriovenous (AV) dialysis circuit is designed for repetitive access to perform hemodialysis. Patients on long-term dialysis will usually have an AV fistula (created by directly connecting a native vein to a native artery) or an AV graft (created by using an artificial tube attached on one end to a vein and the other end to an artery) for easy, repeated vascular access.
There is a bundled code set (36901-36909) describing procedures performed within the dialysis circuit, including three add-on codes. Here’s what you need to know for proper use of these add-on codes.
- Codes +36907 and +36908 describe procedures performed through direct access to the dialysis circuit.
- Codes +36907 and +36908 describe procedures performed in the CENTRAL SEGMENT ONLY.
- If interventions are performed in the central segment from an approach OTHER THAN through the dialysis circuit, these codes are NOT assigned.
- Like the primary codes in this series, +36907 and +36908 are built on a hierarchical scale – meaning +36908 (stenting) includes the services of and is valued higher than, +36907 (angioplasty).
- Codes +36907 and +36908 can only be reported once, no matter how many lesions are treated in the central segment.
- Code +36909 is specific to embolization performed in the dialysis circuit.
- Code +36909 should be assigned when embolizing the main vessel or any/all side branches emptying into the dialysis circuit itself.
- When selectively engaging the vessel(s) to embolize, it is not appropriate to assign any catheter placement codes with +36909.
- Code +36909 can only be reported once per encounter, no matter how many vessels are treated.
- None of these 3 add-on codes include diagnostic imaging, so they can be reported with 36901.
|Angioplasty within the central segment of the dialysis circuit||X||X|
|Stent placement within the central segment of the dialysis circuit||X|
|Embolization performed within the dialysis circuit – including main and/or any accessory vessels||X|