AMA Clinical Examples in Radiology - 2020 Issue 1 (Winter)
Duplex Scan of Arterial Inflow and Venous Outflow Prior to Hemodialysis
CLINICAL EXAMPLE 1 Duplex Scan of Arterial Inflow and Venous Outflow Prior to Hemodialysis CLINICAL HISTORY End-stage renal disease (ESRD). Patient in need of hemodialysis. Procedure is for preoperative mapping prior to surgical creation of arteriovenous fistula (AVF) for dialysis access. Study performed per the Kidney Disease Outcomes Quality Initiative (KDOQI) Guidelines. FINDINGS Right Upper Extremity Veins: Subclavian vein: patent Axillary vein: patent Brachial vein 1: patent; superior 3 mm, mid 2-3 mm, at elbow 1-2 mm Brachial vein 2: patent; superior 3-4 mm, mid 2 mm, at elbow 3 mm Basilic vein: patent; superior 5 mm, mid 6...
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Article Overview
This article explains a hemodialysis access preoperative vessel-mapping scenario and discusses the coding context around the study. It is aimed at coders and clinicians working with vascular ultrasound, dialysis access planning, and diagnosis reporting, and it covers CPT, HCPCS Level II history, ICD-10-CM diagnosis selection, and references to CMS and KDOQI-related guidance.
Why This Topic Matters
Accurate reporting of preoperative dialysis access imaging depends on understanding the appropriate procedure code family, the shift in reporting over time, and the related diagnosis coding context. This article helps readers determine whether a bilateral or unilateral study context is being addressed and how the scenario fits into broader documentation and coverage considerations.
Article Sections
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Clinical Example 1
A hemodialysis access preoperative mapping scenario is presented with vascular ultrasound findings for both upper extremities.
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How to Code
The article presents the associated procedural and diagnosis codes for this clinical scenario.
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Discussion
Background information is provided on historical reporting, later code changes, the role of vessel mapping, and related coverage or documentation context.
What You Will Learn
- How the article frames a preoperative hemodialysis access ultrasound case
- What general coding topics are associated with the study
- How the discussion situates the case within historical and current coding guidance
- What broader documentation and coverage considerations may apply
Who Should Read This
- Medical coders
- Coding auditors
- Radiology professionals
- Nephrology clinicians
- Dialysis access planners
- Compliance staff
Codes Discussed
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