CPT® Code 76936

Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging)

The CPT® Code 76936 refers to the procedure known as ultrasound guided compression repair of an arterial pseudoaneurysm (PSA) or arteriovenous fistulae (AVF). This procedure is particularly relevant in cases following angiography or in patients undergoing dialysis who may experience complications from AVF needle punctures. A pseudoaneurysm is defined as an abnormal, extravascular cavity that fills with blood, which is formed through a channel that connects to the arterial lumen. In contrast, an arteriovenous fistula is a type of shunt that allows blood to flow directly from an artery to a vein, leading to increased diastolic flow in the artery and turbulence in the draining vein. Patients may present with symptoms such as significant pain, bruising, or the formation of a hematoma at the site of the procedure. The ultrasound guided compression technique involves the use of diagnostic ultrasound to evaluate the affected area for any signs of bleeding, to check the patency of the vessel, and to identify the neck of the pseudoaneurysm or the tract of the arteriovenous fistula. During the procedure, a transducer is utilized to apply pressure to the lesion, which is carefully titrated to occlude blood flow within the PSA or AVF while ensuring that adequate blood flow to the artery is maintained. The procedure includes intermittent release of pressure at intervals of 10 to 15 minutes to monitor for thrombosis. The procedure concludes either when successful thrombosis is achieved or if it becomes necessary to terminate the procedure due to inadequate blood flow to the artery or if the patient cannot tolerate the procedure any longer.