Arterial 93925 & ABI 93922. Combination Ultrasound Exam.
Assessment of the Ankle brachial indices (ABI) only is considered part of the physical examination and is not covered according to Title XVIII of the Social Security Act section 1862 (a) (7) which excludes routine physical examinations and services from Medicare coverage.
The following is a list of procedures considered reasonable for Medicare reimbursement for the evaluation of new-onset DVT: Duplex scan (93970 or 93971). Doppler waveform analysis including responses to compression and other maneuvers (93965).
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 ...
According to the Medicare LCD policy for non-invasive vascular testing, there are no specified limitations about billing an ABI with limited ultrasound. Reviewing the CCI edits for the two CPT codes listed, CPT 76882 is considered to be a component of CPT 93922 but may be reimbursed separately with modifier -59.
Medicare Part B covers many types of outpatient doctor-ordered tests like urinalysis, tissue specimen tests, and screening tests. There are no copays for these tests, but your deductibles still apply. *Medicare covers diagnostic mammograms more often if your doctor orders them.
The physician reviews the duplex scan and provides a written interpretation of findings. Assign CPT code 93970 for a complete bilateral study of the upper or lower extremity veins. Assign code 93971 for a unilateral or limited study.
On codes 93970 and 93971, the distinction is greater than just unilateral or bilateral. 93970 is defined as a complete bilateral study, and as such must meet this definition exactly to be reported. 93971 is a unilateral or limited study, and can be used for a limited bilateral service as well as a unilateral.
CPT 93922 is defined as "non-invasive physiologic studies of upper or lower extremity arteries, single level, bilateral (e.g., ankle/brachial indices, Doppler waveform analysis, volume plethysmography, transcutaneous oxygen tension measurement)." CPT 93923 is defined as "non-invasive physiologic studies of upper or ...
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.
Use ICD-10-CM code Z09 only to describe a limited venous duplex (CPT code 93971) performed within 72 hours of a saphenous vein ablation procedure (CPT codes 36473, 36474, 36475, 36476, 36478, 36479, 36482, or 36483).
CPT® 93925 in section: Duplex scan of lower extremity arteries or arterial bypass grafts.