Dialysis circuit coding contains a multitude of codes, each with its own nuances and rationale. CPT® gives options for code choices that are built upon a hierarchy, from procedures performed within the dialysis circuit through access directly into the circuit. Although there are several options based on the coding scenario, coders and compliance personnel must remember that only one code from 36901–36906 may be reported for the same session. While not discussed in this insight, be aware that 36907–36909 are add-on codes in this series. These add-on codes, when appropriate, must be reported with one code from the 36901–36906 series. Let’s discuss some of the main codes that comprise this series.
Code 36901 may be reported for direct access into the dialysis circuit for diagnostic imaging. However, this code is only reported for scenarios without any subsequent therapeutic intervention in the peripheral segment during the same session.
Note that you should not report 36901 with 36902, 36903, 36904, 36905, or 36906. However, 36901 may be reported for diagnostic imaging of the dialysis circuit in addition to the procedures described for add-on codes 36907–36908.
What does 36901 include? It details one or more accesses into the dialysis graft/fistula and imaging of the entire dialysis graft circuit from the arterial anastomosis through the central veins. If the catheter must be maneuvered up to and into the vena cava or across the arterial anastomosis to better visualize the graft, those catheterizations are included in 36901. Understand that code 36901 also encompasses catheterization and imaging of venous side branches, when necessary.
When a dialysis fistulagram is performed without further intervention within the peripheral segment of the dialysis circuit, report code 36901 with modifier 52, if the fistulagram is accomplished by injection of contrast into an existing access.
| 36902 | Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous outflow including the inferior or superior vena cava, fluoroscopic guidance, radiological supervision and interpretation and image documentation and report; with transluminal balloon angioplasty, peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty |
Code 36902 should be reported when diagnostic angiography of the dialysis circuit is performed along with angioplasty within the peripheral segment. It may be tempting to report 36902 for every lesion treated; however, this code may be reported only once, regardless of the lesion number. Code 36902 includes angioplasty of the arterial peri-anastomotic area. Angioplasty codes (37246–37249) may not be reported for angioplasties within the dialysis circuit. Also, note that 36901 must not be reported in addition to 36902. Moreover, for balloon removal of the arterial plug, do not report 36902. In this instance, see code 36904.
| 36903 | Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous outflow including the inferior or superior vena cava, fluoroscopic guidance, radiological supervision and interpretation and image documentation and report; with transcatheter placement of intravascular stent(s), peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the stenting, and all angioplasty within the peripheral dialysis segment |
Code 36903 is reported for diagnostic imaging of the dialysis circuit plus stent placement in the peripheral segment. Angioplasty, if performed, is included in this code and is not separately reported, even when separate lesions are treated. Report code 36903 only once, regardless of the number of stents placed within the peripheral segment. Do not report codes 36901 and/or 36902 with 36903.
| 36904 | Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angiography, fluoroscopic guidance, catheter placement(s), and intraprocedural pharmacological thrombolytic injection(s); |
When is 36904 reported vs 36903? Report 36904 for diagnostic imaging plus mechanical thrombectomy and/or thrombolytic infusion within the dialysis circuit. This code includes thrombectomy and/or infusion in the peripheral and/or central segments. Code 36904 includes lyse-and-wait technique, use of Trerotola® or other mechanical devices, suction of thrombus, removal of the arterial plug, intra-graft thrombolysis, and balloon maceration of thrombus.
Do not report codes 36901, 36902, or 36903 along with 36904.
These are not all the necessary coding tips and rationale essential for basic interventional radiology knowledge and dialysis circuit coding. As service volumes rebound and every dollar counts more than ever, it is imperative to make sure your CPT® coding is correct and compliant. Master more interventional radiology topics and break down the complexity with our expert-infused Diagnostic and Therapeutic Dialysis Shunt Interventional Radiology Coding webcast. This webcast is an essential training tool for both audio and visual learners.
Last week I read a research letter dealing with family physician burnout published in the Journal of the American Medical Association (JAMA) Internal Medicine. It
I had planned a different topic for this week, sequencing sepsis, based on feedback from my last article, but an article about OpenEvidence rolling out
Please log in to your account to comment on this article.
Gain clarity and confidence in OB‑GYN coding with this expert‑led webcast featuring Stacey Shillito, CDIP, CPMA, CCS, CCS‑P, CPEDC, COPC. You’ll learn how to apply global maternity package rules accurately, select the right CPT codes for procedures and visits, and identify documentation gaps that lead to denials. With practical guidance and real examples, this session helps you strengthen compliance, reduce audit risk, and ensure accurate reimbursement for women’s health services.
Uncover essential coding insights with nationally recognized coding authority Kay Piper, RHIA, CDIP, CCS. Through ICD10monitor’s interactive, on‑demand webcast series, Kay walks you through the AHA’s 2026 ICD‑10‑CM/PCS Quarterly Coding Clinics, translating each update into practical, easy‑to‑apply guidance designed to sharpen precision, ensure compliance, and strengthen day‑to‑day decision‑making. Available shortly after each official release.
Uncover critical guidance on the ICD-10-CM/PCS code updates. Kay Piper reviews and explains ICD-10-CM/PCS coding guidelines in the AHA’s fourth quarter 2026 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
Uncover critical guidance on the ICD-10-CM/PCS code updates. Kay Piper reviews and explains ICD-10-CM/PCS coding guidelines in the AHA’s third quarter 2026 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
Federal auditors are intensifying their focus on inpatient psychiatric facilities, using advanced data analytics to spotlight outliers and pursue high‑dollar repayments. In this high‑impact webcast, Michael Calahan, PA, MBA, Compliance Officer and V.P., Hospital & Physician Compliance, breaks down what regulators are really targeting in IPF-PPS admissions, documentation, treatment and discharge planning. Attendees will learn practical steps to tighten processes, avoid common audit triggers and protect reimbursement and reduce the risk of multimillion-dollar repayment demands.
In this timely session, Stacey Shillito, CDIP, CPMA, CCS, CCS-P, CPEDC, COPC, breaks down the complexities of Medical Decision Making (MDM) documentation so providers can confidently capture the true complexity of their care. Attendees will learn practical, efficient strategies to ensure documentation aligns with current E/M guidelines, supports accurate coding, and reduces audit risk, all without adding to charting time.
Join Ronald Hirsch, MD, FACP, CHCQM for The PEPPER Returns – Risk and Opportunity at Your Fingertips, a practical webcast that demystifies the PEPPER and shows you how to turn complex claims data into actionable insights. Dr. Hirsch will explain how to interpret key measures, identify compliance risks, uncover missed revenue opportunities, and understand new updates in the PEPPER, all to help your organization stay ahead of audits and use this powerful data proactively.
Stay ahead of the 2026-2027 audit surge with “Top 10 Audit Targets for 2026-2027 for Hospitals & Physicians: Protect Your Revenue,” a high-impact webcast led by Michael Calahan, PA, MBA. This concise session gives hospitals and physicians clear insight into the most likely federal audit targets, such as E/M services, split/shared and critical care, observation and admissions, device credits, and Two-Midnight Rule changes, and shows how to tighten documentation, coding, and internal processes to reduce denials, recoupments, and penalties. Attendees walk away with practical best practices to protect revenue, strengthen compliance, and better prepare their teams for inevitable audits.
Celebrate Lab Week with MedLearn! Sign up to win one year of our Laboratory All Access Pass! Click here to learn more →
BLOOM INTO SAVINGS! Get 25% OFF during our spring sale through March 27. Use code SPRING26 at checkout to claim this offer.
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 1 with code CYBER25
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24
