CPT® Code 36907

Add-On Code

Transluminal balloon angioplasty, central dialysis segment, performed through dialysis circuit, including all imaging and radiological supervision and interpretation required to perform the angioplasty (List separately in addition to code for primary procedure)

Transluminal balloon angioplasty, as described by CPT® Code 36907, is a medical procedure aimed at restoring adequate blood flow through a narrowed or obstructed central venous dialysis segment. This segment may include critical veins such as the axillary vein, subclavian vein, innominate vein, or vena cava. The procedure is particularly relevant for patients experiencing hemodialysis-related central venous occlusive disease (CVOD), which can manifest through symptoms such as elevated urea recirculation, increased venous dialysis pressure, and arm edema. The access point for this procedure is typically through an arteriovenous (AV) graft or fistula, which is punctured with a needle to facilitate the introduction of a guidewire. Following this, a vascular sheath is placed, allowing for the insertion of a catheter that enables angiography to visualize the affected central venous segments. If stenosis, or narrowing, is detected, a balloon-tipped catheter is utilized to perform the angioplasty. This involves inflating the balloon with a radiopaque contrast agent under fluoroscopic guidance to ensure proper visualization and effectiveness. After the procedure, if residual stenosis is identified, a stent may be deployed to maintain vessel patency. The entire process includes necessary imaging and radiological supervision, ensuring that the procedure is conducted safely and effectively.