AMA CPT® Assistant - 2010 Issue 3 (March)
Dialysis Access (Codes 36147 and 36148) (March 2010)
March 2010 page 3 Dialysis Access (Codes 36147 and 36148) Background To reflect current clinical practice, CPT codes 36147 , 36148 , and 75791 have been established to report the -diagnostic angiographic evaluation of an arteriovenous (AV) shunt. CPT code 36147 includes the work of establishing a single percutaneous access into the AV shunt with diagnostic contrast imaging of the dialysis circuit. However, if a fistulagram is performed without direct puncture and/or catheter placement into the hemodialysis shunt, that service would be reported with the radiology code 75791 . In addition, code 75791 may also be used: for a fistulagram in an...
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Article Overview
This article covers CPT guidance for dialysis access imaging and access-related reporting in patients with arteriovenous shunts used for hemodialysis. It explains the scope of the applicable CPT and radiology codes, discusses when the services are used, and outlines the general clinical and procedural setting addressed by the guidance. The article is relevant to coders, billers, and clinical documentation teams working with ESRD-related vascular access studies and related imaging interpretation.
Why This Topic Matters
Dialysis access studies can involve overlapping imaging and access steps, so understanding the coding framework helps support accurate reporting and consistent documentation review. The article is useful for distinguishing among related CPT and radiology reporting categories in this specialized clinical setting.
Article Sections
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Background
Introduces the purpose of the guidance and the broader coding context for dialysis access imaging and access-related services.
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Coding for AV Shunt Imaging
Summarizes the overall framework for reporting AV shunt imaging and related access activity, along with the general relationship among the referenced codes.
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Clinical Setting
Describes the patient population and clinical circumstances in which these services are commonly considered.
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Typical Procedure
Provides a high-level procedural overview of how dialysis access imaging is performed and the general type of intervention that may follow.
What You Will Learn
- How the article frames CPT guidance for dialysis access imaging services
- What broader clinical situations commonly lead to evaluation of an AV shunt
- How the article presents the relationship between imaging and access-related reporting
- What procedural setting is described for dialysis access studies
Who Should Read This
- Medical coders
- Billing staff
- Clinical documentation specialists
- Revenue cycle professionals
- Interventional radiology teams
- Nephrology-related practices
Codes Discussed
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