With budgets stretched to the brink for many hospitals and facilities, every coding dollar counts in 2026. Complexity cuts into coding accuracy, leaving countless opportunities for errors—especially in interventional radiology. Dialysis circuit interventions are governed by a tightly bundled set of codes that capture both diagnostic imaging and therapeutic services within the access circuit. From a standalone fistulagram to angioplasty, stent placement, or thrombectomy, each code reflects a distinct level of intervention while including extensive imaging and supervision. Often, these services may not be reported together, making it all the more important to understand the differences, which are essential for compliant, accurate reimbursement. Let’s explore some expert-backed tips to start the path to successful coding in 2026.
The first key to success is understanding the basics of direct access. Report code 36901 for direct access into the dialysis circuit for diagnostic imaging, without any subsequent therapeutic intervention in the peripheral segment at the same session. Coders should be careful not to report 36901 with 36902, 36903, 36904, 36905, or 36906. However, code 36901 may be reported for diagnostic imaging of the dialysis circuit in addition to the procedures described in codes 36907–36908. What does the code specifically encompass? This code includes one or more accesses into the dialysis graft/fistula and imaging of the entire dialysis graft circuit from the arterial anastomosis through the central veins. Under the circumstances that the catheter must be maneuvered up to and into the vena cava or across the arterial anastomosis to better visualize the graft, those catheterizations are included in 36901. Code 36901 also includes catheterization and imaging of venous side branches when necessary.
| 36901 | Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous outflow including the inferior or superior vena cava, fluoroscopic guidance, radiological supervision and interpretation and image documentation and report; |
Selecting modifiers also remains a prime source of confusion: which modifiers should be applied, when, and under what circumstances? When performing a dialysis fistulagram without further intervention within the peripheral segment of the dialysis circuit, report code 36901 with modifier 52 if the fistulagram is performed by injection of contrast into an existing access.
| 36902 | Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous outflow including the inferior or superior vena cava, fluoroscopic guidance, radiological supervision and interpretation and image documentation and report; with transluminal balloon angioplasty, peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty. |
Code 36902 should be reported when diagnostic angiography of the dialysis circuit is performed along with angioplasty within the peripheral segment. Note that code 36902 may be reported only once, no matter how many lesions are treated. This code includes angioplasty of the arterial peri-anastomotic area. Coders should exercise caution when it comes to the circumstances of reporting:
Report code 36903 for diagnostic imaging of the dialysis circuit plus stent placement in the peripheral segment. Angioplasty, if performed, is included and not separately reported, even when separate lesions are treated. Report code 36903 only once regardless of the number of stents placed within the peripheral segment. Do not report codes 36901 and/or 36902 along with 36903.
| 36903 | Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous outflow including the inferior or superior vena cava, fluoroscopic guidance, radiological supervision and interpretation and image documentation and report; with transcatheter placement of intravascular stent(s), peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the stenting, and all angioplasty within the peripheral dialysis segment. |
These are only some of the codes within the coding family. To understand the full breadth of services and scope, discover more of MedLearn’s resources.
The patient with a left forearm AV fistula presented for due to low flow. After standard prep and sterile draping, the arterial anastomosis was accessed with a 21-gauge needle. A 5-French catheter was advanced through the fistula under fluoroscopic guidance. Contrast was injected, and diagnostic imaging was obtained from the arterial anastomosis through the entire venous outflow, including the cephalic vein and subclavian vein. Venous side branches were also visualized. No angioplasty, stent placement, or thrombolysis was performed. Radiological supervision, interpretation, and documentation were completed.
⚠️Your IR Coding Remains Under Threat, Creating Significant Risk to Your Bottom Line. These Are NOT All the Tips and Tricks Necessary for Success.⚠️
With every dollar of reimbursement counting more than ever in the face of payment decline and complex changes, it’s imperative to make sure your CPT® coding is correct and compliant. Master more coding topics and break down the complexity our 2026 IR Masterclass: Diagnostic and Therapeutic Dialysis Shunt Interventional Radiology Coding webcast March 11, 2026 at 11:00 am CT. This webcast is an essential training tool for both audio and visual learners.
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