AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2020 Issue 3; Ask the Editor

Repair of Aneurysm of Arteriovenous Fistula with Endovenectomy

A 51-year-old male with end-stage renal disease (ESRD) presents for repair of an aneurysm of his right brachiocephalic arteriovenous (AV) fistula. A 4 cm incision was made through the subcutaneous tissue; the fistula was exposed, and the aneurysmal section of the fistula was opened with a blade. Heavily calcified rock-like pieces were then removed from the aneurysm, essentially endovenectomizing the lumen. The excess cephalic vein wall was excised, and the edges were plicated with stitches in order to reduce the size and flow of the fistula. What is the correct ICD-10-PCS code(s) for this fistula aneurysm repair? Is the removal of the calcified pieces coded separately? ...

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