2025 CPT code 36819
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Surgery Feed
Open arteriovenous anastomosis created by upper arm basilic vein transposition.
Modifiers 50 (bilateral procedure) and 59 (distinct procedural service) may be applicable depending on the circumstances.
Medical necessity is established by the patient’s need for hemodialysis and the unsuitability of other vascular access sites.Documentation must support the need for this procedure.
The surgeon is responsible for all aspects of the procedure, from prepping and anesthetizing the patient to creating the anastomosis, controlling bleeding, and closing the wound.
In simple words: The doctor creates a connection between a vein and an artery in the upper arm to make it easier for a person with kidney failure to get hemodialysis (kidney dialysis).
This CPT code, 36819, represents the creation of an open arteriovenous anastomosis using basilic vein transposition in the upper arm.The procedure involves making incisions over the basilic vein and brachial artery, creating a tunnel between them, and connecting the transposed basilic vein to the brachial artery to establish hemodialysis access.Hemostasis and wound closure are included.
Example 1: A patient with end-stage renal disease requires hemodialysis access. The surgeon performs an arteriovenous anastomosis using the basilic vein in the upper arm, creating a fistula for dialysis access., A patient has failed previous arteriovenous fistulas in their forearm.The surgeon opts for a basilic vein transposition in the upper arm to create a more robust hemodialysis access site., During a routine physical exam, a patient is found to have unsuitable veins in the forearm for hemodialysis access.The surgeon plans for a basilic vein transposition in the upper arm during a scheduled surgical procedure.
* Preoperative assessment of vascular access sites.* Intraoperative documentation of the technique used for the arteriovenous anastomosis, including vein size and patency.* Postoperative assessment of the patency of the created fistula.* Images (e.g., ultrasound, angiography) documenting the location and patency of the anastomosis pre- and postoperatively.
** This procedure is commonly performed for patients requiring hemodialysis.Careful patient selection is essential, considering factors such as vein size, location, and overall health.
- Revenue Code: P2F (MAJOR PROCEDURE, CARDIOVASCULAR - OTHER)
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Vascular Surgery, Nephrology
- Place of Service:Ambulatory Surgical Center, Hospital Outpatient