Radiology Question for the Week of February 20, 2023

Question:

What do codes 36836 and 36837 describe and what is the difference between the codes?

Answer:

Codes 36836, and 36837 describe percutaneous arteriovenous fistula creation in the upper extremity for hemodialysis access, including image-guided percutaneous access into a peripheral artery and peripheral vein via single access (36836) or two separate access sites (36837). The artery and vein are approximated and then energy (eg, thermal) is applied to establish the fistulous communication between the two vessels. Fistula maturation procedures promote blood flow through the newly created fistula by augmentation (eg, angioplasty) or redirection (eg, coil embolization of collateral pathways) of blood flow. Codes 36836, and 36837 include all vascular access, angiography, imaging guidance, and blood flow redirection or maturation techniques (eg, transluminal balloon angioplasty, coil embolization) performed for fistula creation. These procedures may not be reported separately with 36836, 36837 when performed in the same operative session.

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