AV Graft Coding: Basilic Vein Transposition In 2 Stages

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Question:

I do a basilic vein transposition for AV access in two stages. The code 36819 is for doing the procedure all in the same time. How do I report it in 2 stages?

Answer:

To report this procedure in 2 stages report, 36821 for stage I, the direct basilic vein to brachial artery transposition, since it is essentially performing an AV fistula. For Stage II, the superficialization of the patent brachio-basilic vein fistula, report an AV graft revision, 36832. Report 36832 with a 58 modifier since 36821 has a 90 day global. Remember to document in the operative note for 36821 that a staged procedure is planned.

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