patient underwent a duplex scan of lower extremity arteries, bilaterally, report code 93925.

by Mr. Madison Hansen 8 min read

Duplex Scan Of Lower Extremity Arteries – 93925, 93926 …

10 hours ago Procedure code and Description Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral. 93925 A complete duplex scan of the lower extremity arteries includes examination of the full length of the common femoral, superficial femoral and popliteal arteries.The iliac, deep femoral, and tibioperoneal arteries may also be examined. >> Go To The Portal


Report these codes under the circumstance that evaluation is performed of an arterial bypass within the lower extremity including the surrounding or adjacent vessels. 93925 Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study

Full Answer

What is the CPT code for duplex scan of lower extremity?

Procedure code and Description Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral. 93925 A complete duplex scan of the lower extremity arteries includes examination of the full length of the common femoral, superficial femoral and popliteal arteries.

When to assign a 93976 duplex scan of the abdomen?

If both arterial inflow and venous outflow are not noted, assign 93976 Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study.

Do not report a duplex scan code?

Do not separately report a duplex scan code for the use of a simple hand-held or other Doppler device that does not output a hard copy, or that produces a record that does not analyze bidirectional vascular flow, because it’s considered part of the physical examination of the vascular system.

What is the CPT code for duplex scan of aorta?

If the examined single vessel is not studied through its entire course, assign the limited code 93979 Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study.

What does CPT code 93925 mean?

Duplex scan of lower extremity arteriesCPT® 93925 in section: Duplex scan of lower extremity arteries or arterial bypass grafts.

Does 93925 need a modifier?

If performed in a physician-owned, non-facility setting in which the physician owns the equipment, employs the staff, and performs and reads the study, no modifier is required as this constitutes global billing.

Is CPT code 93925 an ultrasound?

The provider performs a duplex ultrasound scan of the lower extremity arteries or bypass grafts on both sides. Providers perform noninvasive arterial diagnostic procedures to examine the rate of blood flow and to assess the presence of blockage in the lower extremity arteries.

What is duplex scan of lower extremity arteries?

A lower extremity arterial duplex test is like an echo on the heart but it scans the arteries in the legs. It uses sound waves to look into the vessels checking for blockages or narrowing of the arteries. The word "Duplex" is also called "Doppler", "Ultrasound, or "Sonogram".

Is CPT 93925 covered by Medicare?

Medicare expects that one of the “V”-codes listed below be billed as the primary diagnosis when billing CPT/HCPCS codes 93922, 93923, 93924, 93925, 93926, 93930 and 93931 for preoperative examination of patients with clinically suspected vascular disease who will undergo a lower extremity surgical procedure for which ...

How often can you bill 93925?

Billing Frequency Limitations For CPT codes 93880 through 93888, 93925 through 93931, 93970 through 93979, 93985 and 93986, billing frequency is limited to two per consecutive 12-month period, per code, by any provider, for the same recipient.

What is the CPT code for us duplex venous lower extremity?

CPT code 93971 (Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study) for the following: Preoperative examination of potential harvest vein grafts to be used during bypass surgery.

What is the CPT code for lower extremity ultrasound?

Extremity ultrasound (CPT codes 76881 and 76882) is limited to studies of the arms and legs.

What is an arterial duplex?

Ultrasound is a procedure that uses sound waves to "see" inside your body. An arterial duplex ultrasound uses sound waves to create a color map of the arteries in your legs to identify: Narrowing of your vessels that may be causing leg pain when walking.

What is bilateral lower extremity venous duplex?

Purpose of the Test This ultrasound helps us to see the arteries that carry blood to the legs. It uses high frequency sound waves. This test finds blockages in the leg arteries and grades the severity of these blockages.

What is the difference between an ultrasound and a duplex scan?

Assessing blood flow through your limbs' arteries A duplex ultrasound combines a traditional ultrasound, which uses sound waves that bounce off blood vessels to create an image, and Doppler ultrasound, which records sound waves that bounce off moving objects, such as blood, to measure speed and flow.

What is a peripheral artery duplex?

Arterial Duplex sonography displays two-dimensional structures and movements with time and Doppler ultrasonic signals. The generated signals provide documentation with spectrum analysis and color flow velocity mapping.

What is a duplex scan?

Duplex scans combine conventional ultrasound with Doppler imaging. While conventional ultrasound imaging views the structure of blood vessels, Doppler ultrasound views the movement and speed of blood through these vessels.

What is a duplex ultrasound?

Duplex ultrasound is a non-invasive evaluation of blood flow in the arteries and veins comprised of real-time images integrat ing B-mode, two-dimensional vascular structure, Doppler spectral analysis, and color flow Doppler imaging.#N#Duplex scans combine conventional ultrasound with Doppler imaging. While conventional ultrasound imaging views the structure of blood vessels, Doppler ultrasound views the movement and speed of blood through these vessels. By combining these two methods of imaging, duplex scans produce color-coded images that show physicians where blood flow is blocked, as well as the extent of a blockage. Duplex scans may be used, for example, to diagnose peripheral vascular or arterial disease.

What is CPT code book?

It is important to be aware of several requirements outlined in the CPT® code book for reporting duplex studies. CPT® guidelines explain that non-invasive vascular studies include patient care required to perform non-invasive vascular studies and include supervision of the studies and interpretation of the study results.

Why is duplex scan so tricky?

Coding for duplex scans can be tricky because provider reports do not always include the necessary documentation. Here’s what you need to know about common duplex exams and the documentation challenges they present.

What is a 93971 scan?

If any of the required elements are not documented, report instead 93971 Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study.

Is a Doppler study necessary for a duplex study?

A common question is whether a test order is necessary to perform a duplex study when an ultrasound has been ordered by the referring physician.#N#Doppler studies should not be routinely added to ultrasounds. Performing a Doppler study with an ordered ultrasound is considered to be a test design exception, according to the rules for ordering diagnostic tests. The Doppler study must be medically necessary to accurately diagnose the patient, and the radiologist should document a detailed explanation of why the Doppler was medically necessary in the procedure report. ( Clinical Examples in Radiology, Vol. 9, Issue 1: Winter 2013).

Can a tibioperoneal artery be imaged?

The deep femoral and tibioperoneal arteries may be imaged, if indicated , but it is not required for a complete exam. If an evaluation is performed of a lower extremity arterial bypass graft, the study must include the complete course of the lower extremity arterial bypass graft.

General Information

CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.

Article Guidance

This First Coast Billing and Coding Article for Local Coverage Determination (LCD) L33667 Duplex Scan of Lower Extremity Arteries provides billing and coding guidance for frequency limitations as well as diagnosis limitations that support diagnosis to procedure code automated denials.

ICD-10-CM Codes that Support Medical Necessity

The following ICD-10-CM codes support medical necessity and provide limited coverage for CPT codes: 93925 and 93926.

What is duplex testing?

Duplex testing is interpreted in conjunction with limb-pressure measurements to accurately categorize arterial hemodynamics and functional impairment. Understanding the features of duplex-acquired velocity spectra recordings is fundamental to accurate diagnostic testing, including the characteristic spectral features of "normal" versus "abnormal" lower-limb arterial flow, hemodynamic changes associated with stenosis or occlusion, and the status of distal limb or foot perfusion. Scanning can provide an arterial map of occlusive or aneurysm lesions analogous to an angiogram. Testing is accurate before and after intervention for the detection of stenosis; a common failure mode after bypass grafting or peripheral angioplasty. The detection of high-grade stenosis in an arterial repair allows for pre-emptive treatment before thrombosis occurs and improves long-term patency.

Is scan an angiogram?

Scanning can provide an arterial map of occlusive or aneurysm lesions analogous to an angiogram. Testing is accurate before and after intervention for the detection of stenosis; a common failure mode after bypass grafting or peripheral angioplasty.

CPT CODE and Description

93925 Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study

Imaging Considerations

This guideline does not supersede the enrollee’s health plan medical policy specific to diagnostic Physiologic Testing for Peripheral Arterial Disease (PAD) of the Upper and Lower Extremities