CPT® Code 36906

Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angiography, fluoroscopic guidance, catheter placement(s), and intraprocedural pharmacological thrombolytic injection(s); 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 circuit

The procedure described by CPT® Code 36906 involves a specialized intervention aimed at addressing blood clots within the dialysis circuit. This circuit may include components such as a central venous catheter (CVC), an arteriovenous (AV) fistula, or a synthetic AV graft. The primary goal of this procedure is to either dissolve or mechanically remove thrombi that can obstruct blood flow, which is critical for effective dialysis treatment. Thrombosis is particularly prevalent in AV grafts, but can also occur in AV fistulas, leading to significant complications if not addressed promptly. Symptoms indicative of thrombosis in the dialysis circuit may include the absence of a palpable thrill or pulse at the site of the fistula or graft, swelling of the vessel, or a lack of blood flash during needle insertion. To accurately assess the extent of the thrombus, imaging techniques such as ultrasound or duplex Doppler studies may be employed. The procedure encompasses various steps, including the use of thrombolytic agents, mechanical thrombectomy techniques, and the potential placement of stents to ensure the patency of the dialysis circuit. This comprehensive approach is essential for restoring adequate blood flow and maintaining the functionality of the dialysis access site.