Question:

What codes can be assigned for extremity arterial non-imaging Doppler studies?

Answer:

If bilateral non-imaging physiologic exams are performed of either the upper or lower extremity arteries, report one of the codes below.

If a unilateral exam is performed, report code 93922, add modifier -52 if only 1 or 2 levels is evaluated. If both the upper and the lower extremity arteries are studied, report one of the following codes twice—once for the upper extremities and once for the lower. Modifier 59 may have to be assigned. Clarify with local payers.

93922 Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (e.g., for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus bidirectional, Doppler waveform recording and analysis at 1–2 levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus volume plethysmography at 1–2 levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries with, transcutaneous oxygen tension measurement at 1–2 levels)
93923 Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (e.g., for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental blood pressure measurements with bidirectional Doppler waveform recording and analysis, at 3 or more levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental volume plethysmography at 3 or more levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental transcutaneous oxygen tension measurements at 3 or more levels), or single level study with provocative functional maneuvers (e.g., measurements with postural provocative tests, or measurements with reactive hyperemia)

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This question was answered in the 2018 edition of our Peripheral & Cardiology Coder. For more hot topics relating to cardiology services, please view our store, or call us at 1.800.252.1578 ext. 2.

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