How To Use CPT Code 36825

CPT 36825 describes the creation of an arteriovenous fistula using an autogenous graft, which is a separate procedure from direct arteriovenous anastomosis. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 36825?

CPT 36825 is used to describe the surgical creation of an arteriovenous fistula using an autogenous graft. This procedure involves connecting an artery and a vein to allow for hemodialysis treatments. Unlike direct arteriovenous anastomosis, which uses cannula insertion, CPT 36825 utilizes a graft taken from the patient’s own body. It is important to note that other procedures performed during the same operative session should be reported separately.

2. Official Description

The official description of CPT code 36825 is: ‘Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); autogenous graft.’

3. Procedure

1. The provider begins by making an incision and locating the vein and artery using radiological imaging.
2. After clearing the area around the artery and vein, the provider dissects them free and attaches vessel clamps to stop the blood flow.
3. An incision is made in the thigh or calf area to obtain a vein that will be used as a graft.
4. The graft is sutured to the artery and vein, creating the connection for the arteriovenous fistula.
5. The provider pulls the graft through a tunnel created just under the skin and attaches one end to the artery and the other end to the vein.
6. The clamps are removed, allowing the blood to flow freely through the graft.
7. The provider stops any bleeding and closes the wound by suturing the soft tissues in layers.

4. Qualifying circumstances

CPT 36825 is performed on patients who require an arteriovenous fistula for hemodialysis access. The procedure involves using an autogenous graft, which is tissue harvested from the patient’s own body. It is important to note that this code should not be reported separately with a related procedure performed through the same skin incision. If the procedure is performed with an unrelated procedure, modifier 59 may need to be appended to CPT 36825.

5. When to use CPT code 36825

CPT code 36825 should be used when a provider creates an arteriovenous fistula using an autogenous graft. It is important to ensure that the documentation supports the procedure as a separate procedure and not part of another related procedure. This code should not be reported with a related procedure performed through the same skin incision. Modifier 59 may be necessary if the procedure is performed with an unrelated procedure.

6. Documentation requirements

To support a claim for CPT 36825, the provider must document the following information:

• Patient’s need for an arteriovenous fistula for hemodialysis access
• Use of an autogenous graft for the procedure
• Date and details of the procedure, including the start and end time
• Any additional procedures performed during the same operative session, documented separately
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 36825, ensure that the procedure involves the creation of an arteriovenous fistula using an autogenous graft. It should not be reported with a related procedure performed through the same skin incision. Modifier 59 may be necessary if the procedure is performed with an unrelated procedure. It is important to review the documentation and ensure that it supports the use of the modifier. Modifier 51 should not be used for multiple procedures in this case.

8. Historical information

CPT 36825 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A surgeon creates an arteriovenous fistula using an autogenous graft for a patient requiring hemodialysis access.
2. A vascular specialist performs the surgical procedure to establish an arteriovenous fistula using an autogenous graft for a patient with end-stage renal disease.
3. A provider surgically creates an arteriovenous fistula using an autogenous graft for a patient who will undergo regular hemodialysis treatments.
4. An interventional radiologist performs the procedure to create an arteriovenous fistula using an autogenous graft for a patient in need of hemodialysis access.
5. A vascular surgeon utilizes an autogenous graft to create an arteriovenous fistula for a patient requiring long-term hemodialysis.
6. A provider performs the surgical procedure to establish an arteriovenous fistula using an autogenous graft for a patient with kidney failure.
7. An interventional radiologist creates an arteriovenous fistula using an autogenous graft for a patient who will undergo hemodialysis treatments.
8. A vascular specialist performs the procedure to create an arteriovenous fistula using an autogenous graft for a patient with chronic kidney disease.
9. A surgeon utilizes an autogenous graft to create an arteriovenous fistula for a patient in need of hemodialysis access.
10. An interventional radiologist performs the surgical procedure to establish an arteriovenous fistula using an autogenous graft for a patient with renal failure.