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This blog is a networking resource for ASDIN members. It is not intended to be utilized as legal or medical advice. ASDIN offers this blog as is, without any express or implied warranties, or other assurances as to the content of the material contained herein. ASDIN assumes no responsibility for errors or omissions contained herein, or for any actions taken or damages suffered by any person on the basis of, or in reliance upon, any of the information contained herein. Cases and images should ALWAYS be stripped of any/all patient-specific information (name, DOB, MR#, etc.). Cases should be well thought out and suitable for distribution. Language usage should be polite, collegial, and professional. If it is found that a participant is not using appropriate language, that participant’s comment may be blocked.


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Top tags: Policy and Procedure  tunneled dialysis catheter  central vein stenosis  Coding  articles of interest  Central Stents  policies  svc thrombus  accessory veins  accessory veins/ Coils  articles of interest; RESCUE  ASC  AVF  case  Consents  Conversion  Declot  Emergency  Great Stuff !!!!  HeRO  Online Survey  PD catheter PERITONEOGRAM  Pennsylvania  pericatheter thrombus  peritoneal dialysis catheters  report  Research  right IJ  SVC thrombus PE 

June 2018 Articles of Interest

Posted By Abigail Falk, Wednesday, June 27, 2018
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INR/plavix and HD procedures

Posted By Fawad Qureshi, Tuesday, June 26, 2018
Recently the interventional radiologists at my current hospital are asking to hold warfarin and normalize the INR before they would do a fistulogram. They also asked to hold Plavix for a day before placing a permanent tunneled HD catheter. Any opinions and experiences from my colleagues on this?

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Brachial artery partial thrombosis

Posted By Martin Gorrochategui, Monday, April 30, 2018

Partial thrombosis of the brachial artery just proximal to the arterial anastomosis

afraid to pull out with fogarty placed on Eliquist instead 

surgeon notified

comments please

 Attached Files:
IMG_3354.MOV (398.42 KB)

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April 2018 Articles

Posted By Abigail Falk, Monday, April 30, 2018
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Music in the IR suite

Posted By Rajeev Narayan, Saturday, April 28, 2018


In an effort to make things a little less serious...


 I wanted to ask fellow interventionalists if they play music in the procedure room and if so, what are their preferences/dislikes. Are is there particular music you play depending on the type of procedure?


in our Fluoroscopy suite we typically have the radio on to a station that typically play's 80's music, which I like, and many of the patients seem to be able to relate to and enjoy.


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Billing Question - Bundling of 36902 with 36581

Posted By Reuben K. Ellis, Tuesday, April 10, 2018

I was just notified by my billing company that one of our major private carriers (UHC) is bundling the 36902 code with 36581 for all their patients. Thus they are denying the 36902. Has anyone else run into this problem and how did you resolve it. I have scheduled a physician to physician conference call with the medical director to express my disagreement with there ruling. I would love to hear anyone else’s similar experience.


Best Regards R Kris Ellis MD FASN, FASDIN

Tags:  Coding 

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March 2018 Articles

Posted By Abigail Falk, Wednesday, March 28, 2018
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Physician Assistant Operator

Posted By James Lin, Monday, March 12, 2018

Does anyone know if you can use a PA as the interventionalist at an extension of practice?

Wondering if the MD has to be present at the facility when the procedure is being performed, like a dialysis visit in the hospital when the pt is on the machine.

I’ve seen other units use PA’s in this fashion with the PA being the person completing the entire procedure but there is always an MD on the premises.

Lastly, if the procedure can be billed under the PA do you only get 80% from CMS?

Thanks in advance.

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February 2018 Articles of Interest

Posted By Abigail Falk, Thursday, March 1, 2018
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January 2018 Articles of Interest

Posted By Abigail Falk, Wednesday, January 24, 2018
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Advice on new C-arm purchase

Posted By Amy C. Dwyer, Tuesday, January 23, 2018

Esteemed colleagues,


My 10-year old Phillips BV Pulsera is wearing out and I am shopping for a new machine. I am looking at the Phillips Veradius Unity and the GE OEC Elite CFD (not the 9900 version). Does anyone have experience with either machine?



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Pennsylvania Help Wanted

Posted By Mary L. Nations, Friday, January 19, 2018

Wanted:  A Vascular Access Center in Pennsylvania that can share requirements or obstacles in licensing as an ASC Center with a fellow ASDIN member.


Direct email to if you are willing to connect.




Tags:  ASC  Conversion  Pennsylvania 

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CMS, Access Centers and AScs

Posted By Pierre J. Souraty, Wednesday, December 20, 2017

Do we have an idea about how many Extension of Practice have closed? (not switched to ASC)

Are there any information about the fact that CMS may pay FGM and access related procedures at EOP rates even if an access center went through the ASC certification? and what, as a Society are we planning to do about it?


Tags:  policies  Policy and Procedure 

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December 2017 Articles of Interest

Posted By Abigail Falk, Monday, December 18, 2017
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Emergency Consenting

Posted By Nephrology Associates PA Vascular Access Center, Wednesday, November 15, 2017

In the event we cannot get consent from a patient, their spouse, guardian or other legal entity, we have had the ordering physician, typically their dialysis Nephrologist that ordered the procedure, and the Interventional Nephrologist who is going to perform the procedure discuss the situation, decide it was in the patient's best interest to have the procedure performed and sign the consent.


I have looked online for emergency consent guidelines however most deal with blood transfusions, minors and don't relate to our situation.  I have found this verbage on several documents:


An emergency must meet all of the following criteria:

a) The patient's life or health must be in immediate and substantial danger.

b) The patient is incapable of consenting.

c) Any potential risks associated with the treatment are materially outweighed by the

potential benefits associated with treatment.


So my question is what do you do in these situations? 

How many signatures do you require on your consent forms if any?

Do you have any P&P's you would be willing to share?


Thank you in advance for your help,


Nicole Davis

Tags:  Consents  Emergency  Policy and Procedure 

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