tci General Surgery Coding Alert - 2004 Issue 4

Reader Question: For Thrombectomy After Fistula, Append -79

Question: The surgeon created an AV fistula in a renal-failure patient. Within a week, the surgeon had to perform a thrombectomy to remove a clot. Will the payer reimburse us for the thrombectomy performed during the global period of the AV fistula?Maryland Subscriber Answer: Yes, the payer should allow separate payment for thrombectomy during the 90-day global period of an arteriovenous (AV) fistula.To claim thrombectomy only, report 36831 (Thrombectomy, open, arteriovenous fistula without revision, autogenous or nonautogenous dialysis graft [separate procedure]). If the surgeon revises/resects the fistula at the same time as the thrombectomy, report 36833 (Revision...

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