Thrombectomy of HeRO® Graft

A patient with a thrombosed right upper extremity hemodialysis reliable outflow (HeRO®) graft underwent thrombectomy of the central aspect and cannulation segment of the graft. An AngioJet™ device was used in several passes to perform rheolytic thrombectomy throughout the graft. A Fogarty balloon was inserted and positioned in the brachial artery just beyond the arterial anastomosis. The device was activated and drawn across the anastomosis and through the graft to clear any residual thrombus. Repeat sweeping with the Fogarty balloon through the retrograde access and repeat thrombectomy with the angiocatheter was performed. Since HeRO® grafts consist of a venous outflow component (tube) in a neck vein connected to a regular dialysis graft (arterial graft component) that is anastomosed to an artery, is this thrombectomy procedure coded to the root operation Extirpation or Revision? What is the correct body part value for the thrombectomy? ...

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Note:  The following article synopsis was NOT provided by the AHA. It was created by Find-A-Code/innoviHealth.

Article Overview

This premium article examines an ICD-10-PCS coding question involving thrombectomy of a HeRO® hemodialysis graft. It focuses on how the procedure is categorized in PCS terms, with attention to the relevant root operation and body part assignment for a graft with both vascular and dialysis access components. The content is useful for inpatient coders, CDI professionals, and anyone working with dialysis access procedures and complex graft anatomy.

Why This Topic Matters

HeRO® graft procedures can involve multiple vascular components and create uncertainty in ICD-10-PCS assignment. Correct classification affects inpatient procedure reporting and supports more consistent coding of dialysis access interventions.

What You Will Learn

  • How the article frames thrombectomy of a HeRO® graft within ICD-10-PCS
  • What coding question is being raised about root operation assignment
  • Why the graft’s structure is relevant to procedure classification
  • How body part selection is discussed for this type of vascular access procedure

Who Should Read This

  • Inpatient coders
  • Coding educators
  • CDI specialists
  • Health information management professionals
  • Dialysis access coders

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