AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2024 Issue 1; Clarifications

Percutaneous Creation of Arteriovenous Fistula with Ellipsys® Vascular Access System

Coding Clinic Fourth Quarter 2021, page 45, states that creation of an arteriovenous fistula (AVF) by connecting the brachial artery to a lower arm vein may be accomplished by using the Ellipsys® Vascular Access System (EVAS) device. Page 60 of the same issue, states that the EVAS device connects the radial artery (to a vein) using thermal resistance energy; however, there is no indication that the brachial artery can also be utilized. Is the EVAS limited to the radial artery with thermal resistance, or is it also used for a percutaneous creation of an AVF connecting a brachial artery to a lower vein without thermal resistance? What is the correct code assignment for the creation of an AVF by connecting the brachial artery to a lower arm vein using the EVAS device? ...

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