Question:
Patient came for follow-up after a right upper extremity arteriovenous graft placement. She has developed steal syndrome, recommended to proceed with banding of the graft in order to alleviate the steal syndrome. Should we report code 37607 or 36832 for reducing the size of graft and banding of graft?

“Distal part of the graft just above the anastomosis was cleaned and dissected free from all the old clot and previously placed Surgi-Flo. A 2 cm wide pericardial patch was opened and washed and irrigation. A segment of the patch was cut and placed circumferentially around the graft just above the anastomosis. The size of the patch was designed in such a way to decrease the size of the graft to half. The segment of the graft wrapped by the pericardial patch was decreased to about 5 mm. The patch was closed around the graft using multiple interrupted 6-0 Prolene stitches. The hand and wrist were examined.”

Answer:
Report code 37607.

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