How To Use CPT Code 36830

CPT 36830 describes the creation of an arteriovenous fistula using a nonautogenous graft, which is a separate procedure. 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 36830?

CPT 36830 can be used to describe the surgical procedure in which a provider creates an arteriovenous fistula using a nonautogenous graft. This procedure involves connecting an artery and a vein using a synthetic material made up of biological collagen fibers or thermoplastic. The purpose of this procedure is to allow for hemodialysis treatments in patients with advanced, permanent kidney failure.

2. Official Description

The official description of CPT code 36830 is: ‘Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); nonautogenous graft (eg, biological collagen, thermoplastic 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.
3. Next, the provider attaches a vessel clamp on each to stop the blood flow.
4. A nonautogenous graft, which is a synthetic material made of biological collagen fibers or thermoplastic, is then sutured to the artery and vein.
5. To create the fistula, the provider pulls the graft through a tunnel created just under the skin to attach the artery to the vein.
6. The provider removes the clamps from the blood vessels, allowing the blood to flow freely through the graft.
7. Finally, the provider stops any bleeding and closes the wound by suturing the soft tissues in layers.

4. Qualifying circumstances

CPT 36830 is performed on patients who require an arteriovenous fistula for hemodialysis treatments. The procedure involves the use of a nonautogenous graft, such as a synthetic material made of biological collagen fibers or thermoplastic. It is important to note that this code should not be reported separately with a related procedure performed in the same anatomical region through the same skin incision. Modifier 59 may be necessary if the procedure is performed with an unrelated procedure.

5. When to use CPT code 36830

CPT code 36830 should be used when a provider performs the creation of an arteriovenous fistula using a nonautogenous graft as a separate procedure. It should not be reported with a related procedure performed in the same anatomical region 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 36830, the provider must document the following information:

• Patient’s diagnosis and the need for the creation of an arteriovenous fistula
• Use of a nonautogenous graft, such as a synthetic material made of biological collagen fibers or thermoplastic
• Date of the procedure
• Details of the procedure, including the incision, dissection, attachment of the graft, creation of the fistula, and closure of the wound
• Any additional relevant information, such as the use of radiological imaging
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 36830, ensure that the procedure involves the creation of an arteriovenous fistula using a nonautogenous graft. It should not be reported separately with a related procedure performed in the same anatomical region 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 specific guidelines of the payer to ensure accurate billing.

8. Historical information

CPT 36830 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition. It is important to stay updated with any changes or revisions to the code in future editions of the CPT manual.

9. Examples

1. A surgeon performs the creation of an arteriovenous fistula using a nonautogenous graft for a patient with end-stage renal disease requiring hemodialysis.
2. A vascular specialist surgically creates an arteriovenous fistula using a nonautogenous graft for a patient with advanced kidney failure.
3. A provider performs the creation of an arteriovenous fistula using a nonautogenous graft to establish vascular access for hemodialysis treatments in a patient with chronic kidney disease.
4. An interventional radiologist performs the creation of an arteriovenous fistula using a nonautogenous graft for a patient with renal failure.
5. A surgeon performs the creation of an arteriovenous fistula using a nonautogenous graft to provide vascular access for hemodialysis in a patient with end-stage renal disease.