Multiple Specialists Perform Percutaneous Hemodialysis (HD) Access Interventions (original) (raw)

Abstract

Background: Interventions to improve maturation or prolong the function of HD access are common. Interventional radiologists (IR) have traditionally done these services in hospitals. Recently, internists/interventional nephrologists (IN) and access surgeons (AS) have begun to perform these access salvage procedures. The extent of this shift in practice is not well documented. Methods: We reviewed CY 2009 claims submitted to the Centers for Medicare & Medicaid Services (CMS) for dialysis-related access procedures done in NW5. We grouped practitioners by self-designated CMS specialty codes: AS (gen surg 2, thorac surg 33, vasc surg 76+77), IN (int med 11, nephrology 39) and IR (diagnostic radiol 30, interventional radiol 94). We grouped procedures by CPT code: fistulography (36145), percutaneous (precut) interventions (angioplasty 35476, G0392, G0393; and percut thrombectomy 36870), tunneled catheter (HD cath) placement (36558), HD cath exchange (36581), AVF or AVG construction (36818...

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