© Copyright 2025 American Medical Association. All rights reserved.
A congenital arteriovenous fistula is a vascular anomaly characterized by an abnormal connection between an artery and a vein that is present from birth. This condition can manifest in various locations throughout the vascular system and can differ significantly in terms of size and length. The presence of this abnormal communication allows blood to flow from the artery into the vein under high pressure. Since the walls of veins are not designed to withstand such high-pressure blood flow, they can become distended, leading to an enlargement of the venous structure. This increased blood flow can result in various cardiovascular complications over time. Repairing congenital arteriovenous fistulas can be particularly challenging due to their potential extension into surrounding anatomical structures. To facilitate the repair process, angiography may be performed to accurately map the course of the fistula. The surgical procedure involves exposing the fistula, isolating it from surrounding tissues, and then severing the abnormal connection. The artery and vein are subsequently repaired, either with sutures or by using a synthetic patch or vein graft, ensuring that normal blood flow is restored. This procedure is specifically designated for cases involving the extremities, distinguishing it from similar repairs in other anatomical regions.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure for repairing a congenital arteriovenous fistula in the extremities is indicated for patients presenting with the following conditions:
The procedure for repairing a congenital arteriovenous fistula in the extremities involves several critical steps:
Post-procedure care for patients who have undergone repair of a congenital arteriovenous fistula in the extremities typically includes monitoring for any signs of complications, such as bleeding or infection at the surgical site. Patients may be advised to limit physical activity for a specified period to allow for proper healing. Follow-up appointments are essential to assess the success of the repair and to ensure that normal blood flow has been restored without any recurrence of the fistula. Additionally, patients may require imaging studies in the future to monitor the vascular status of the affected area.
| Short Descr | RPR CGEN AV FISTULA XTR | Medium Descr | REPAIR CONGENITAL AV FISTULA EXTREMITIES | Long Descr | Repair, congenital arteriovenous fistula; extremities | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P2F - Major procedure, cardiovascular-Other | MUE | 2 | CCS Clinical Classification | 61 - Other OR procedures on vessels other than head and neck |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) |
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| 2025-01-01 | Changed | Short and Medium Descriptions changed. |
| 2013-01-01 | Changed | Medium Descriptor changed. |
| Pre-1990 | Added | Code added. |