CPT® Code 75791

Code deleted. See 36901, 36902, 36903, 36904, 36905, 36906.

Official Description

Angiography, arteriovenous shunt (eg, dialysis patient fistula/graft), complete evaluation of dialysis access, including fluoroscopy, image documentation and report (includes injections of contrast and all necessary imaging from the arterial anastomosis and adjacent artery through entire venous outflow including the inferior or superior vena cava), radiological supervision and interpretation

Common Language Description

The CPT® Code 75791 refers to a specialized imaging procedure known as angiography, specifically targeting arteriovenous shunts, which are commonly utilized in patients undergoing dialysis. This complete evaluation of dialysis access involves a thorough assessment of the shunt, including the arteriovenous fistula or graft. The procedure is characterized by the use of fluoroscopy, a real-time imaging technique that allows for the visualization of the shunt and surrounding blood vessels during the injection of contrast media. The physician plays a crucial role in this process, providing radiological supervision and interpretation throughout the procedure. The term 'shuntogram' or 'fistulogram' may also be used to describe this procedure, highlighting its focus on the evaluation of the vascular access points used for dialysis. During the angiography, contrast material is injected into the arteriovenous shunt or an adjacent blood vessel, enabling the capture of a series of radiographs at specific intervals. This imaging captures the flow of blood through the shunt and adjacent vessels, allowing the physician to monitor and assess the functionality of the dialysis access. Following the imaging, the physician reviews the obtained radiographs and compiles a comprehensive written report interpreting the findings, which is essential for determining the adequacy and patency of the dialysis access site.

1. Indications

The procedure described by CPT® Code 75791 is indicated for the evaluation of arteriovenous shunts, particularly in patients who require dialysis. The following conditions may warrant this angiographic assessment:

Dialysis Access Evaluation This procedure is performed to assess the functionality and patency of arteriovenous fistulas or grafts used for hemodialysis.
Investigation of Complications It is indicated when there are complications such as thrombosis, stenosis, or other issues affecting the blood flow through the dialysis access.
Preoperative Assessment The angiography may be necessary prior to surgical interventions to ensure the adequacy of the vascular access.

2. Procedure

The angiography procedure as described by CPT® Code 75791 involves several critical steps to ensure a comprehensive evaluation of the arteriovenous shunt:

Step 1: Patient Preparation The patient is positioned appropriately, and the area of the arteriovenous shunt is prepared for the procedure. This may include cleaning the skin and administering local anesthesia if necessary.
Step 2: Contrast Injection A contrast agent is injected into the arteriovenous shunt or an adjacent blood vessel. This step is crucial as it allows for the visualization of the blood flow through the shunt during imaging.
Step 3: Imaging Acquisition Using fluoroscopy, a series of radiographs are obtained at timed intervals. This real-time imaging enables the physician to observe the flow of blood through the shunt and surrounding vessels, capturing any abnormalities or issues.
Step 4: Radiological Supervision Throughout the procedure, the physician provides supervision and interpretation of the fluoroscopic images, ensuring that all necessary views are obtained for a complete evaluation.
Step 5: Interpretation and Reporting After the imaging is completed, the physician reviews the radiographs and compiles a detailed report interpreting the findings, which is essential for further management of the patient's dialysis access.

3. Post-Procedure

Post-procedure care following the angiography of the arteriovenous shunt typically involves monitoring the patient for any immediate complications related to the contrast injection or the procedure itself. Patients may be observed for signs of bleeding at the injection site or any adverse reactions to the contrast material. It is also important to assess the functionality of the shunt after the procedure, ensuring that blood flow remains adequate for dialysis. The physician will provide instructions regarding any necessary follow-up appointments or additional imaging studies if required, based on the findings from the angiography.

Short Descr	AV DIALYSIS SHUNT IMAGING
Medium Descr	ANGIOGRPHY AV SHUNT COMPLETE EVAL FLUOR RS&I
Long Descr	Angiography, arteriovenous shunt (eg, dialysis patient fistula/graft), complete evaluation of dialysis access, including fluoroscopy, image documentation and report (includes injections of contrast and all necessary imaging from the arterial anastomosis and adjacent artery through entire venous outflow including the inferior or superior vena cava), radiological supervision and interpretation
Status Code	Active Code
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	1 - Diagnostic Tests for Radiology Services
Multiple Procedures (51)	6 -
Bilateral Surgery (50)	0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions	9 - Concept does not apply.
Assistant Surgeon (80, 82)	0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62)	0 - Co-surgeons not permitted for this procedure.
Team Surgery (66)	0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	T-Packaged Codes
Type of Service (TOS)	4 - Diagnostic Radiology
Berenson-Eggers TOS (BETOS)	I2D - Advanced imaging - MRI/MRA: other
MUE	Not applicable/unspecified.
CCS Clinical Classification	191 - Arterio- or venogram (not heart and head)