CPT® Code 0876T

Official Description

Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)

Common Language Description

The CPT® Code 0876T refers to a specialized diagnostic procedure known as a duplex scan of a hemodialysis fistula. This procedure employs computer-aided technology to perform a limited evaluation focusing on critical parameters such as volume flow, diameter, and depth of the fistula, specifically examining only the body of the fistula. The hemodialysis fistula, which is an arteriovenous (AV) connection created for patients requiring dialysis, is assessed to identify and localize any abnormalities that may impede its function. These abnormalities can include stenotic lesions, which are narrowings of the blood vessel that can restrict blood flow, as well as hematomas, which are localized collections of blood outside of blood vessels, and calcifications that may affect the fistula's integrity. During the procedure, the patient is positioned semi-reclined, with the arm or leg containing the fistula rotated outward and extended at approximately a 45-degree angle to facilitate optimal imaging. A high-frequency transducer is utilized, with frequency settings adjusted to suit the specific application and the depth of the tissue being examined. The limited nature of the scan means that it focuses on the entire length of the body of the fistula, specifically measuring volume flow at the mid-brachial artery while avoiding areas that may exhibit stenosis, calcification, or tortuosity. The examination includes assessing the size and depth of the fistula, and the computer-aided measurements obtained during the scan are crucial for determining the maturity of the fistula, as well as evaluating the blood flow and patency, which are essential for the successful performance of hemodialysis.

1. Indications

The duplex scan of a hemodialysis fistula is indicated for the following conditions:

Assessment of Fistula Maturity This procedure is performed to evaluate whether the arteriovenous fistula has matured adequately for effective hemodialysis.
Detection of Abnormalities The scan helps identify abnormalities such as stenotic lesions, hematomas, and calcifications that may affect the function of the fistula.
Evaluation of Patency It is used to determine the patency of the fistula, ensuring that it is open and functioning properly for dialysis.
Monitoring Blood Flow The procedure measures the volume flow within the fistula, which is critical for assessing its performance during hemodialysis.

2. Procedure

The procedure for conducting a duplex scan of a hemodialysis fistula involves several key steps:

Patient Positioning The patient is positioned in a semi-reclined manner, with the arm or leg containing the fistula rotated outward and extended at approximately a 45-degree angle. This positioning is essential for optimal access and visualization of the fistula during the scan.
Transducer Application A high-frequency transducer is selected based on the specific application and the depth of the tissue being examined. The transducer is then applied to the skin over the body of the fistula to initiate the ultrasound evaluation.
Limited Scan Execution The technician performs a limited scan that examines the entire length of the body of the fistula. This includes taking volume flow measurements specifically at the mid-brachial artery while avoiding any areas that may show signs of stenosis, calcification, or tortuosity.
Measurement and Analysis During the scan, the size and depth of the fistula are assessed. Computer-aided measurements are taken to evaluate the maturity of the fistula, the amount of blood flow, and the overall patency of the fistula.

3. Post-Procedure

After the duplex scan of the hemodialysis fistula, there are no specific post-procedure care requirements mentioned. However, it is generally expected that the patient may resume normal activities immediately following the procedure. The results of the scan should be documented and communicated to the healthcare provider for further evaluation and management of the patient's hemodialysis treatment plan. Any abnormalities detected during the scan may necessitate additional follow-up or intervention to ensure the continued functionality of the fistula.

Short Descr	DUPLEX SCAN HEMO FSTL LMTD
Medium Descr	DUPLEX SCAN HEMODIALYSIS FISTULA CPTR AIDED LMTD
Long Descr	Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)
Status Code	Carriers Price the Code
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	1 - Diagnostic Tests for Radiology Services
Multiple Procedures (51)	4 - Special payment adjustment rules on the technical component (TC) of multiple diagnostic imaging procedures apply...
Bilateral Surgery (50)	1 - 150% payment adjustment for bilateral procedures applies.
Physician Supervisions	09 - 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	88 -
APC Status Indicator	Non-Covered Service, not paid under OPPS
Berenson-Eggers TOS (BETOS)	none
MUE	1