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CPT®
36145

CPT® Code 36145
Deleted

Official Description

Introduction of needle or intracatheter; arteriovenous shunt created for dialysis (cannula, fistula, or graft)

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 36145 involves the introduction of a needle or intracatheter into an arteriovenous shunt that has been created for the purpose of dialysis. An arteriovenous shunt is a surgical connection made between an artery and a vein, which can take the form of a cannula, fistula, or graft. This connection is essential for patients undergoing dialysis, as it allows for efficient access to the bloodstream for the removal of waste products and excess fluid. Prior to the procedure, the skin over the shunt is disinfected to minimize the risk of infection, and a local anesthetic is administered to ensure patient comfort during the insertion process. The healthcare provider then carefully inserts a needle or intracatheter into the shunt, which may be used for the injection of medication or radiopaque contrast material, depending on the clinical requirements. After the injection is completed, the needle or intracatheter is withdrawn, and pressure is applied to the puncture site to prevent bleeding. This procedure is critical in facilitating dialysis treatment and ensuring that the shunt remains functional for ongoing patient care.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure associated with CPT® Code 36145 is indicated for patients who require access to their bloodstream for dialysis treatment. The following conditions may warrant the use of this procedure:

  • End-Stage Renal Disease (ESRD) Patients diagnosed with ESRD often require dialysis to manage their condition, necessitating the creation of an arteriovenous shunt for effective treatment.
  • Acute Kidney Injury (AKI) In cases of AKI where dialysis is needed, an arteriovenous shunt may be established to facilitate the procedure.
  • Vascular Access for Hemodialysis Patients who need reliable vascular access for hemodialysis may require the introduction of a needle or intracatheter into an existing arteriovenous shunt.

2. Procedure

The procedure for CPT® Code 36145 involves several critical steps to ensure proper access to the arteriovenous shunt:

  • Step 1: Preparation The healthcare provider begins by preparing the site of the arteriovenous shunt. This includes disinfecting the skin over the shunt to reduce the risk of infection. A local anesthetic is then administered to minimize discomfort for the patient during the procedure.
  • Step 2: Insertion of Needle or Intracatheter Once the area is prepared and the patient is comfortable, the provider carefully inserts a needle or intracatheter into the arteriovenous shunt. This step is crucial as it allows for access to the bloodstream for subsequent procedures.
  • Step 3: Injection of Medication or Contrast After successful insertion, the provider may perform an injection of medication or radiopaque contrast material as needed for diagnostic or therapeutic purposes. This step is essential for ensuring that the shunt is functioning properly and for any imaging studies that may be required.
  • Step 4: Removal and Post-Procedure Care Following the completion of the injection, the needle or intracatheter is carefully removed. The provider then applies pressure to the puncture site to prevent any bleeding, ensuring that the site is secure before concluding the procedure.

3. Post-Procedure

After the procedure associated with CPT® Code 36145, it is important to monitor the puncture site for any signs of bleeding or infection. The patient may be advised to rest and avoid strenuous activities for a short period to allow for proper healing. Additionally, healthcare providers may provide specific instructions regarding care for the arteriovenous shunt, including signs and symptoms to watch for that may indicate complications. Regular follow-up appointments may be scheduled to assess the function of the shunt and ensure that it remains patent for ongoing dialysis treatments.
Short Descr ARTERY TO VEIN SHUNT
Medium Descr ARTERY TO VEIN SHUNT
Long Descr INTRO NDL/INTRACATH ARVEN SHUNT CREATED DIAL
APC Status Indicator Items and Services Packaged into APC Rates
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) none
MUE Not applicable/unspecified.
CCS Clinical Classification 54 - Other vascular catheterization, not heart
Date
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Notes
2010-01-01 Deleted -
Pre-1990 Added Code added.
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