CPT® Code 36815

The CPT® Code 36815 refers to the insertion of a cannula for hemodialysis or other purposes, specifically focusing on the external revision or closure of an arteriovenous shunt. A cannula is a flexible tube that is inserted into a vein or artery to facilitate the flow of blood during hemodialysis, a procedure that removes waste products and excess fluid from the blood when the kidneys are not functioning properly. In this context, the procedure involves the careful selection of suitable veins, typically in the nondominant forearm, where the blood vessels are exposed and incised to allow for the insertion of the cannulas. The cannulas are then secured with sutures, and the distal segments of the selected veins are ligated to ensure proper blood flow during dialysis. The procedure may also involve the use of a Scribner-type arteriovenous cannula, which is a semi-permanent shunt that connects a peripheral artery and vein, allowing for efficient blood access during dialysis. Although this type of cannula is rarely used today, it is important to understand its role in the overall process. The cannulas are connected to tubing that links directly to the dialysis machine, enabling the removal of waste and excess fluid from the bloodstream. The CPT® Code 36815 is specifically designated for cases where there is a need for external revision of the shunt, which may involve the removal of existing cannulas and the insertion of new ones, or for the closure of the shunt, where the cannulas are removed, and the vessels are sutured closed. This code is essential for accurately documenting and billing for these specific procedures in the context of hemodialysis treatment.