10 Things You Need to Know About Dialysis Circuit Add-on Codes

The arteriovenous (AV) dialysis circuit is designed for repetitive access to perform hemodialysis. Patients on long-term dialysis will usually have an AV fistula (created by directly connecting a native vein to a native artery) or an AV graft (created by using an artificial tube attached on one end to a vein and the other end to an artery) for easy, repeated vascular access.

There is a bundled code set (36901-36909) describing procedures performed within the dialysis circuit, including three add-on codes. Here’s what you need to know for proper use of these add-on codes.

  1. Codes +36907 and +36908 describe procedures performed through direct access to the dialysis circuit.
  2. Codes +36907 and +36908 describe procedures performed in the CENTRAL SEGMENT ONLY.
  3. If interventions are performed in the central segment from an approach OTHER THAN through the dialysis circuit, these codes are NOT assigned.
  4. Like the primary codes in this series, +36907 and +36908 are built on a hierarchical scale – meaning +36908 (stenting) includes the services of and is valued higher than, +36907 (angioplasty).
  5. Codes +36907 and +36908 can only be reported once, no matter how many lesions are treated in the central segment.
  6. Code +36909 is specific to embolization performed in the dialysis circuit.
  7. Code +36909 should be assigned when embolizing the main vessel or any/all side branches emptying into the dialysis circuit itself.
  8. When selectively engaging the vessel(s) to embolize, it is not appropriate to assign any catheter placement codes with +36909.
  9. Code +36909 can only be reported once per encounter, no matter how many vessels are treated.
  10. None of these 3 add-on codes include diagnostic imaging, so they can be reported with 36901.
  +36907 +36908 +36909
Angioplasty within the central segment of the dialysis circuit X X  
Stent placement within the central segment of the dialysis circuit   X  
Embolization performed within the dialysis circuit – including main and/or any accessory vessels     X
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Bryan Nordley

Bryan Nordley is a seasoned professional writer, strategist, and researcher with over a decade’s worth of combined experience. Bryan launched his professional health writing career at the University of British Columbia’s Faculty of Medicine, one of the top 30 faculty of medicine programs in the world, working under the School of Public Health as a communications assistant. From there, he expanded his expertise and knowledge into private healthcare and podiatry before taking the role of healthcare writer at MedLearn Media. Bryan is the lead writer for the MedLearn Publishing brand previously producing both the acclaimed radiology and laboratory compliance manager newsletter products, while currently writing the compliance questions of the week which reach over 10,000 subscribers, creating the MedLearn Publishing Insights blogs and collaborating with operations and nationally renowned subject matter experts, in addition to serving as an editor for a variety of MedLearn publications along with marketing initiatives. Bryan continues to keep his pulse on the latest healthcare industry news, analyzing and reporting with strategic insight.

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