(Base Units + Time [in units]) x CF = Anesthesia Fee Amount Professional Anesthesia Nationwide Base Units by CPT Code: I: v3.16: Outpatient Dental Professional Nationwide Charges by HCPCS Code: J: v3.16: Pathology and Laboratory Services Relative Value Units (RVUs) K: >#cyU=A=l9- kH ..Z;! To discover more about all MSN has to offer, complete the MSN Services Inquiry form. 2012 American Dental Association. Services that are "medically directed" are reimbursed at 50 percent of the amount received if the service was personally performed. 4. Definitions of personally performed, medically directed and medically supervised: Section 50, Definition of concurrent procedures: Section 50.C, Anesthesia claims modifiers: Section 50.I, Billing Modifiers for qualified nonphysician anesthetists: Section 140.3.3, Additional information regarding anesthesia modifiers is available in the Palmetto GBA Modifier Lookup Tool. Since Medicare anesthesia rules, with one exception, do not permit the physician performing a surgical or diagnostic procedure to separately report anesthesia for the procedure the RS&I code(s) shall not be reported by the same physician reporting the anesthesia service. Several CPT codes (01951-01999, excluding 01996) describe anesthesia services for burn excision/debridement, obstetrical, and other procedures. The actual or anticipated postoperative pain must be severe enough to require treatment by techniques beyond the experience of the operating physician. (CPT code 01936 was deleted January 1, 2022.) End Users do not act for or on behalf of CMS. 64400-64530 (Peripheral nerve blocks bolus injection or continuous infusion) CPT codes 64400-64530 (Peripheral nerve blocks bolus injection or continuous infusion) may be reported on the date of surgery if performed for postoperative pain management only if the operative anesthesia is general anesthesia, subarachnoid injection, or epidural injection and the adequacy of the intraoperative anesthesia is not dependent on the peripheral nerve block. The retirement of MIPS #44: Coronary Artery Bypass Graft (CABG): Preoperative Beta-Blocker in Patients with Isolated CABG Surgery measure from the MIPS program. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CDT for resale and/or license, transferring copies of CDT to any party not bound by this agreement, creating any modified or derivative work of CDT, or making any commercial use of CDT. Please call Member Services to order. 2007 0 obj <>stream However, if it is medically necessary for the anesthesia practitioner to continuously monitor the patient during the interval time and not perform any other service, the interval time may be included in the anesthesia time. The Modifying Units identified by each code are added to the Base Unit Value for the anesthesia service according to the above Standard Anesthesia Formula. Providers reporting services under Medicares hospital Outpatient Prospective Payment System (OPPS) shall report all services in accordance with appropriate Medicare IOM instructions. 1998 0 obj <>/Filter/FlateDecode/ID[<23E955A0C9657144967B3AB09FA92D2E>]/Index[1980 28]/Info 1979 0 R/Length 88/Prev 127633/Root 1981 0 R/Size 2008/Type/XRef/W[1 2 1]>>stream Any questions pertaining to the license or use of the CPT must be addressed to the AMA. CMS recognizes this type of anesthesia service as a payable service if medically reasonable and necessary. ASAs physician and staff leadership will carefully review the entire 2,414-page rule and we will post more information in the coming weeks. For example, the operating physician may request that the anesthesia practitioner administer an epidural or peripheral nerve block to treat actual or anticipated postoperative pain. ","URL":"","Target":"_self","Color":"blue","Mode":"Standard\n","Priority":"no"}, Please answer the questions below so that we can connect you with an agent. CMS issued aCY 2023 Medicare Physician Fee Schedule (PFS) final rule to expand access to behavioral health care, cancer screening coverage, and dental care. CPT code 36591 describes collection of blood specimen from a completely implantable venous access device. 0 bodies, lumbar or sacral, Thermal destruction of intraosseous basivertebral nerve,inclusive of all imaging guidance; each additional CMS expects to publish the 2022 MIPS measure specifications and other regulatory guidance within the next few weeks on the QPP website. ) Several nerve block CPT codes (e.g., 64416 (brachial plexus), 64446 (sciatic nerve), 64448 (femoral nerve), 64449 (lumbar plexus)) describe continuous infusion by catheter (including catheter placement). Anesthesia time is defined as the period during which an anesthesia practitioner is present with the patient. Code 00740is deleted for 2018. Modifier 59 or XU may be used to indicate that a peripheral nerve block injection was performed for postoperative pain management, rather than intraoperative anesthesia, and a procedure note shall be included in the medical record. Separate payment is not allowed for the anesthesia service performed by the physician who also furnishes the medical or surgical service. American Hospital Association ("AHA"), Anesthesia for Procedures on the Thorax (Chest Wall and Shoulder Girdle), Anesthesia for Procedures on the Spine and Spinal Cord, Anesthesia for Procedures on the Upper Abdomen, Anesthesia for Procedures on the Lower Abdomen, Anesthesia for Procedures on the Perineum, Anesthesia for Procedures on the Pelvis (Except Hip), Anesthesia for Procedures on the Upper Leg (Except Knee), Jury Convicts Physician for Misappropriating $250K From COVID-19 Relief, REVCON Wrap-up: Mastering the Revenue Cycle, OIG Audit Prompts ASPR to Improve Its Oversight of HPP, Check Out All the New Codes for Reporting Services and Supplies to Medicare, HELP PLEASE! See all of the eBooks that we have published in one place. CPT code 01996 may only be reported for management for days subsequent to the date of insertion of the epidural or subarachnoid catheter. document.getElementById( "ak_js_17" ).setAttribute( "value", ( new Date() ).getTime() ); document.getElementById( "ak_js_18" ).setAttribute( "value", ( new Date() ).getTime() ); This field is for validation purposes and should be left unchanged. If you would like to learn more about MSN services for your practice, please call us or use the form below. The following codes are paid per occurrence: CPT 01953, CPT 01967, CPT 01968, CPT CPT 01969, CPT 01996, CPT 99100, CPT 99116, CPT 99135 and CPT 99140. Applications are available at the American Dental Association website. Types of anesthesia include local, regional, epidural, general, moderate conscious sedation, or monitored anesthesia care. Postoperative pain management services are generally provided by the surgeon who is reimbursed under a global payment policy related to the procedure and shall not be reported by the anesthesia practitioner unless separate, medically necessary services are required that cannot be rendered by the surgeon. 5. The surgeon is responsible for documenting in the medical record the reason that care is being referred to the anesthesia practitioner. Sign up below to receive regular industry news! The formula to calculate the allowed amount for anesthesia is: (Base Units + Time [in units]) x CF = Anesthesia Fee Amount The base units assigned to anesthesia CPT codes and the annual anesthesia conversion factors are available at the CMS Anesthesiologists Center. CPT codes 01916-01936 describe anesthesia for radiological procedures. I am wondering if there is anyone on this forum that might understand anesthesia billing for a CRNA in a Critical Access Hospital billing under Method II? For unlisted anesthesia procedures, meaning those procedures or services that do not have a more specific and appropriate CPT code available, the code set includes 01999. It starts when the anesthesia practitioner begins to prepare the patient for anesthesia services in the operating room or an equivalent area and ends when the anesthesia practitioner is no longer furnishing anesthesia services to the patient (i.e., when the patient may be placed safely under postoperative care). The anesthesia base units are unchanged for CY 2019. In some cases, a code listed under a body part grouping may be specific to a procedure, such as endoscopic retrograde cholangiopancreatography (ERCP). We encourage practices to check their billing systems and coding software to ensure that crosswalk files are updated accordingly. document.getElementById( "ak_js_11" ).setAttribute( "value", ( new Date() ).getTime() ); document.getElementById( "ak_js_12" ).setAttribute( "value", ( new Date() ).getTime() ); document.getElementById( "ak_js_13" ).setAttribute( "value", ( new Date() ).getTime() ); document.getElementById( "ak_js_14" ).setAttribute( "value", ( new Date() ).getTime() ); document.getElementById( "ak_js_15" ).setAttribute( "value", ( new Date() ).getTime() ); document.getElementById( "ak_js_16" ).setAttribute( "value", ( new Date() ).getTime() ); See the appropriate billing and collections opportunities that your current billing systems are missing. An epidural injection for postoperative pain management may be separately reportable with an anesthesia 0XXXX code only if the patient receives a general anesthetic and the adequacy of the intraoperative anesthesia is not dependent on the epidural injection. License to use CPT for any use not authorized herein must be obtained through the AMA, CPT Intellectual Property Services, 515 N. State Street, Chicago, IL 60610. Pain Medicine: The work Relative Value Units ( RVUs) two new codes for basivertebral lesioning and for facet joint denervation (codes 64633-64636) are announced within the rule. If a narcotic or other analgesic is injected postoperatively through the same catheter as the anesthetic agent, CPT codes 62320- 62327 shall not be reported for postoperative pain management. If an epidural or peripheral nerve block injection (62320-62327 or 64400-64530 as identified above) for postoperative pain management is reported separately on the same date of service as an anesthesia 0XXXX code, modifier 59 or XU may be appended to the epidural or peripheral nerve block injection code (62320-62327 or 64400-64530 as identified above) to indicate that it was administered for postoperative pain management. An AA always performs anesthesia services under the direction of an anesthesiologist. The COVID19 pandemic and nationwide shutdown that started in March 2020 placed a spotlight on crisis preparedness within the U.S. hea Dont assume the codes youve been using to report drugs and biologicals still apply. 2021 (v4.215) Reasonable Charges Data Tables, Version 4.215 - Dated January 01, 2021; . Several general guidelines are repeated in this Chapter. The rule includes payment and quality provisions that take effect on January 1, 2022. If a physician performing a radiologic procedure inserts a catheter as part of that procedure, and through the same site a catheter is used for monitoring purposes, it is inappropriate for either the anesthesia practitioner or the physician performing the radiologic procedure to separately report placement of the monitoring catheter (e.g., CPT codes 36500, 36555-36556, 36568-36569, 36580, 36584, 36597). If this evaluation occurs after the anesthesia practitioner has safely placed the patient under postoperative care, neither additional anesthesia time units nor E&M codes shall be reported for this evaluation. For example, Anesthesia Rules [e.g., CMS InternetOnly Manual (IOM), Publication 100-04 (Medicare Claims Processing Manual), Chapter 12 (Physician/Nonphysician Practitioners), Section 50(Payment for Anesthesiology Services)] Anesthesia Services CPT Codesand Global Surgery Rules [e.g., CMS InternetOnly Manual (IOM), Publication 100-04 (Medicare Claims Processing Manual), Chapter 12 (Physician/Nonphysician Practitioners), Section 40 (Surgeons and Global Surgery)] do not apply to hospitals. I have a question regarding the QZ mo Hello, After this period, monitoring will commence again for the cataract extraction and ultimately the patient will be released to the surgeons care or to recovery. All Rights Reserved. anesthesia time units; do not add base units or modifier units to the time units. Treatment of postoperative pain by the operating physician is not separately reportable. 4. Intraoperative neurophysiology testing (HCPCS/CPT codes 95940, 95941/G0453) shall not be reported by the physician/anesthesia practitioner performing an anesthesia procedure, since it is included in the global package for the primary service code. Thermal destruction of intraosseous basivertebral nerve,inclusive of all imaging guidance; first two vertebral 5. Anesthesia Billing is complicated. You, your employees, and agents are authorized to use CPT only as contained in the following authorized materials (web pages, PDF documents, Excel documents, Word documents, text files, Power Point presentations and/or any Flash media) internally within your organization within the United States for the sole use by yourself, employees, and agents. What are the CMS Anesthesia Guidelines for 2021? 3. For unlisted anesthesia procedures, meaning those procedures or services that do not have a more specific and appropriate CPT code available, the code set includes 01999. If the operating physician requests that the anesthesia practitioner perform pain management services after the postoperative anesthesia care period terminates, the anesthesia practitioner may report it separately using modifier 59 or XU. CPT Codes Anesthesia Anesthesia for Intrathoracic Procedures 00532 00530 00532 00534 CPT 00532, Under Anesthesia for Intrathoracic Procedures The Current Procedural Terminology (CPT ) code 00532 as maintained by American Medical Association, is a medical procedural code under the range - Anesthesia for Intrathoracic Procedures. Contact Fusion Anesthesia for your anesthesia billing questions! The appropriate RS&I code may be reported by the appropriate provider/supplier (e.g., radiologist, cardiologist, neurosurgeon, radiation oncologist). If the foregoing terms and conditions are acceptable to you, please indicate your agreement by clicking below on the button labeled I ACCEPT. Reverse CROSSWALK is only available as an electronic file for download. The AMA disclaims responsibility for any errors in CPT that may arise as a result of CPT being used in conjunction with any software and/or hardware system that is not Year 2000 compliant. In counting anesthesia time, the anesthesia practitioner can add blocks of time around an interruption in anesthesia time as long as the anesthesia practitioner is furnishing continuous anesthesia care within the time periods around the interruption. CPT code 01996 may be reported with one unit of service per day on subsequent days until the catheter is removed. CPT codes 01916-01936 describe anesthesia for radiological procedures. AS USED HEREIN, YOU AND YOUR REFER TO YOU AND ANY ORGANIZATION ON BEHALF OF WHICH YOU ARE ACTING. The formula to calculate the allowed amount for anesthesia is: *O'R*l2n,&{E|Vt+ )36W-4qUK}8(;StWjfbcn/~ /L/TY. table h. professional anesthesia nationwide base units by cpt code v3.27 (january - december 2020) page 3 of 6 cpt code cpt code description base units 00844 anes iper lower abd w/laps abdominoprnl rescj 7.0 00846 anes iper lower abd w/laps rad hysterectomy 8.0 00848 anes iper lower abd w/laps pelvic exenteration 8.0 Placement of external devices including, but not limited to, those for cardiac monitoring, oximetry, capnography, temperature monitoring, EEG, CNS evoked responses (e.g., BSER), and Doppler flow. Similarly, routine postoperative evaluation is included in the base unit for the anesthesia service. 7. Laryngoscopy (direct or endoscopic) for placement of airway (e.g., endotracheal tube). Medicare generally allows separate reporting for moderate conscious sedation services (CPT codes 99151-99153) when provided by the same physician performing a medical or surgical procedure except when the anesthesia service is bundled into the procedure, e.g., radiation treatment management. means youve safely connected to the .gov website. The interval time and the recovery time are not included in the anesthesia time calculation. Subscribe to Codify by AAPC and get the code details in a flash. It also finalizes an increase in the base unit value that CMS uses for code 00537. The anesthesia CPT codes list covers anesthesia services provided in conjunction with procedures on specific body areas such as the head, neck, spine and spinal cord, upper leg, or elbow. Pain management performed by an anesthesia practitioner after the postoperative anesthesia care period terminates may be separately reportable. This code may be reported only if no other service is reported for the patient encounter. Providers/suppliers may utilize modifier 59 or XE to bypass the edits under these circumstances. The National Correct Coding Initiative (NCCI) program contains many edits bundling standard preparation, monitoring, and procedural services into anesthesia CPT codes. No fee schedules, basic unit, relative values or related listings are included in CPT. cervical or thoracic, Anesthesia for percutaneous image guided neuromodulation or intravertebral procedures (eg.kyphoplasty, vertebroplasty) on the spine or spinal cord; lumbar or sacral. The principles of correct coding discussed in Chapter I apply to the Current Procedural Terminology (CPT) codes in the range 00000-01999. In this case, both the code for the primary anesthesia service and the anesthesia AOC are reported according to CPT Manual instructions. Use is limited to use in Medicare, Medicaid, or other programs administered by the Centers for Medicare & Medicaid Services (CMS). CY 2021 MDWCC MFG Anesthesia Base Units & Calculations v.12/2020 Author: Maryland Workers' Compensation Commission We, at MSN Healthcare Solutions, wish you and your families a happy and healthy new year! All rights reserved. Part of the payment for anesthesia is based on "base units," which are assigned to anesthesia CPT codes by the Centers for Medicare & Medicaid Services (CMS). It also includes the performance of a pre-anesthesia evaluation and examination, prescription of the anesthesia care, administration of necessary oral or parenteral medications, and provision of indicated postoperative anesthesia care. Official websites use .govA These services include, but are not limited to, postoperative pain management and ventilator management unrelated to the anesthesia procedure. In its place 00731 Anesthesia for upper gastrointestinal endosc. To determine the anesthesia base units for any given code please use the Fee Schedule Lookup Tool Use the formula below to calculate the total reimbursement amount for anesthesia codes billed to Utah Medicaid. You acknowledge that the ADA holds all copyright, trademark and other rights in CDT. Covered under the Base Units A basic value is listed for anesthetic management of most surgil d Thii ld th l f ll lical procedures. Value. The CPT codes 99151-99157 describe moderate (conscious) sedation services. Anesthesia: The rule finalizes the base unit values for the six new anesthesia codes. THE CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CPT. Bundled (Never Bill Medicare or Beneficiary) If a surgery is canceled, subsequent to the preoperative evaluation, payment may be allowed to the anesthesiologist for an Evaluation & Management (E&M) service and the appropriate E&M code may be reported. Title 42 - Public Health, Chapter IV CMS/DHHS: Conditions of Participation -, Fourteen states have chosen to opt-out of the CRNA physician supervision regulation -- See. CPT codes describing services that are integral to an anesthesia service include, but are not limited to, the following: 31505, 31515, 31527 (Laryngoscopy) (Laryngoscopy codes describe diagnostic or surgical services), 36000, 36010-36015 (Introduction of needle or catheter) 36400-36440 (Venipuncture and transfusion), 62320-62327 (Epidural or subarachnoid injections of diagnostic or therapeutic substance bolus, intermittent bolus, or continuous infusion). Nerve stimulation for determination of level of paralysis or localization of nerve(s). Browse openings for all members of the care team, everywhere in the U.S. Lead the direction of our specialty by engaging in academic, research, and scientific discovery. Fields with a red asterisk (. 93312-93317 (Transesophageal echocardiography when used for monitoring purposes) However, when performed for diagnostic purposes with documentation including a formal report, this service may be considered a significant, separately identifiable, and separately reportable service. In this Manual, many policies are described using the term physician. document.getElementById( "ak_js_10" ).setAttribute( "value", ( new Date() ).getTime() ); Copyright 2022 Fusion Anesthesia All rights reserved. Also, if unusual services not bundled into the anesthesia service are required, the time spent delivering these services before anesthesia time begins or after it ends may not be included as reportable anesthesia time. 1980 0 obj <> endobj The base units assigned to anesthesia CPT codes and the annual anesthesia conversion factors are available at the CMS Anesthesiologists Center. CPT codes 01916-01933 describe anesthesia for radiological procedures. CRNAs may be paid for E&M services in the critical care area if state law and/or regulation permits them to provide such services. Similar articles that you may find useful: CPT codes, descriptions and other data only are copyright 2012 American Medical Association (or such other date of publication of CPT). vertebral body, lumbar or sacral, Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); Hoping to get some education on which unit value(s) should be submitted when coding Anesthesia CPT (00100-01999 series) When you bill out codes 99151-99157, you enter this on the professional claim of the provider who performed the servicecorrect? If the physician performing the global surgical procedure does not have the skills and experience to manage the postoperative pain and requests that an anesthesia practitioner assume the postoperative pain management, the anesthesia practitioner may report the additional services performed once this responsibility is transferred to the anesthesia practitioner. 81000-81015, 82013, 80345, 82270, 82271(Performance and interpretation of laboratory tests), 43753, 43754, 43755 (Esophageal, gastric intubation), 92511-92520, 92537, 92538(Special otorhinolaryngologic services), 92953 (Temporary transcutaneous pacemaker). Physicians shall not report drug administration CPT codes 96360-96377 for anesthetic agents or other drugs administered between the patients arrival at the operative center and discharge from the post-anesthesia care unit. This Agreement will terminate upon notice if you violate its terms. The conversion factors decrease as anticipated, but ASA and others will continue our work to get Congressional relief. 2251 0 obj <>/Filter/FlateDecode/ID[<9E604C6EA789D54098D8BFF9F6EF4770>]/Index[2236 29]/Info 2235 0 R/Length 76/Prev 100590/Root 2237 0 R/Size 2265/Type/XRef/W[1 2 1]>>stream Individuals and groups receiving less than 75 points will incur a payment penalty on a linear sliding scale up to 9% in 2024 with those scoring under 18.75 points incurring an automatic -9% adjustment. For example, if an anesthesia practitioner who provided anesthesia for a procedure initiates ventilation management in a post-operative recovery area prior to transfer of care to another physician, CPT codes 94002-94003 shall not be reported for this service since it is included in the anesthesia procedure package. Subsequently, an interval of 30 minutes or more may transpire during which time the patient does not require monitoring by an anesthesia practitioner. For Medicare purposes, only one anesthesia code is reported unless the anesthesia code is an Add-on Code (AOC). 6. We are attempting to open this content in a new window. This includes the value for all usual anesthesia services except the time . . Instead, you must click below on the button labeled I DO NOT ACCEPT and exit from this computer screen. Listed below are the base unit value changes for anesthesia proceduresin CY 2021. You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement. Instead, CMS will maintain a completeness of 70% for the next two years. The anesthesia practitioner assumes responsibility for anesthesia and related care rendered in the post-anesthesia recovery period until the patient is released to the surgeon or another physician. Anesthesia: The rule finalizes the base unit values for the six new anesthesia codes. This code range includes anesthesia CPT codes. While an anesthesiologist or non-medically directed CRNA may be able to report this service, only one payment will be made per day. Promoting interoperability and Improvement Activities performance categories will maintain their respective 25% and 15% weights. CHAPTER II ANESTHESIA SERVICES CPT CODES 00000-01999 FOR NATIONAL CORRECT CODING INITIATIVE POLICY MANUAL FOR MEDICARE SERVICES. THE LICENSE GRANTED HEREIN IS EXPRESSLY CONDITIONED UPON YOUR ACCEPTANCE OF ALL TERMS AND CONDITIONS CONTAINED IN THIS AGREEMENT. 1. CPT code 96523 describes irrigation of implanted venous access device for drug delivery system. Patient Billing Inquiries: 1-800-475-6112, 2023 Changes to Medicare Physician Fee Schedule for Anesthesia, Radiology and the ACO: The View from the Back of the Bus, Flexor-plasty, elbow (eg, Steindler type advancement), Flexor-plasty, elbow (eg, Steindler type advancement); with extensor advancement, Reinsertion of ruptured biceps or triceps tendon, distal, with or without tendon graft, Biopsy, soft tissue of pelvis and hip area; superficial, Excision, tumor, soft tissue of pelvis and hip area, subfascial (eg, intramuscular); 5 cm or greater, Excision, tumor, soft tissue of pelvis and hip area, subcutaneous; less than 3 cm, Excision, tumor, soft tissue of pelvis and hip area, subfascial (eg, intramuscular); less than 5 cm, Removal of foreign body, pelvis or hip; subcutaneous tissue, Removal of transvenous pacemaker electrode(s); single lead system, atrial or ventricular, Insertion or replacement of permanent implantable defibrillator system, with transvenous lead(s), single or dual chamber, Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), percutaneous, 6 years and older (includes fluoroscopic guidance, when performed), Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), open, birth through 5 years of age, Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), open, 6 years and older, Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; removal of peripheral (arterial and/or venous) cannula(e), percutaneous, birth through 5 years of age, Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; removal of peripheral (arterial and/or venous) cannula(e), open, birth through 5 years of age, Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; removal of peripheral (arterial and/or venous) cannula(e), open, 6 years and older, 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, 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, Ligation; internal or common carotid artery, Ligation; internal or common carotid artery, with gradual occlusion, as with Selverstone or Crutchfield 5 10 clamp, Ligation, major artery (eg, post-traumatic, rupture); neck.