CPT Code Description
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) (USV Lower Arterial ABI Only).
93923 Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, 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 (eg, measurements with postural provocative tests, or measurements with reactive hyperemia) (USV Upper Arterial W/ABI Non).
93924 Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional doppler waveform or volume plethysmography recording and analysis at rest with ankle/brachial indices immediately after and at timed intervals following performance of a standardized protocol on a motorized treadmill plus recording of time of onset of claudication or other symptoms, maximal walking time, and time to recovery) complete bilateral study.
93925 Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study (USV Lower Arterial W/ABI Non).
93926 Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study.
Coding Guidelines
- Use the appropriate procedure code and modifiers.
- Indicate the diagnoses for which the testing is being performed.
- No paper documentation is required on initial claims submission unless required by an audit or the case deserves special case-by-case review. Place information on claim form as EMC narrative where indicated in the policy, e.g., follow-up studies.
- Upper and lower extremity physiologic studies (CPT-4 codes 93922 and 93923), Lower extremity studies (CPT-4 codes 93925 and 93926), and Upper extremity duplex studies (CPT-4 codes 93930 and 93931)
Supervision:
CMS has determined the following list of procedures require general physician supervision effective July 1 2001:
93875 & TC, 93880 & TC, 93882 & TC, 93886 & TC, 93888 & TC, 93922 & TC, 93923 & TC, 93924 & TC, 93925 & TC, 93926 & TC, 93930 & TC, 93965 & TC, 93970 & TC, 93971 & TC (PM B-01-28, April 19, 2001)
General Supervision is defined as: “The procedure is furnished under the physician’s overall direction and control, but the physician’s presence is not required during the performance of the procedure. Under general supervision, the training of the non-physician personnel who actually performs the diagnostic procedure and the maintenance of the necessary equipment and supplies are the continuing responsibility of the physician.” (PM B-01-28, April 29, 2001).
Noninvasive Tests of Carotid Function
Noninvasive tests of carotid function aid physicians in studying and diagnosing carotid disease. There are varieties of these tests which measure various anatomical and physiological aspects of carotid function, including pressure (systolic, diastolic, and pulse), flow, collateral circulation, and turbulence. For operational purposes, it is useful to classify noninvasive tests of carotid function into direct and indirect tests. The direct tests examine the anatomy and physiology of the carotid artery, while the indirect tests examine hemodynamic changes in the distal beds of the carotid artery (the orbital and cerebral circulations).
It is important to note that the names of these tests are not standardized. Following are some of the acceptable tests, recognizing that this list is not inclusive and that local medical consultants should make determinations:
Direct Tests
•Carotid Phonoangiography
•Direct Bruit Analysis
•Spectral Bruit Analysis
•Doppler Flow Velocity
•Ultrasound Imaging including Real Time
•B-Scan and Doppler Devices
Indirect Tests
•Periorbital Directional Doppler Ultrasonography
•Ocular plethysmography
•Ophthalmodynamometry
Possible ICD-10-CM Diagnosis Codes for Procedure Code 93922, 93923 and 93924
Not all inclusive diagnosis code list. Refer to ICD-10-CM manual for code specificity. Note: Arterial exams must be considered “medically necessary” in order to be eligible for reimbursement
E08-E13 – Diabetes Mellitus
For specificity, refer to additional codes within this category.
ICD-10-CM DIAGNOSIS CODES
E09.59Drug or chemical induced diabetes mellitus with other circulatory complications
E10.59Type 1 diabetes mellitus with other circulatory complications
E11.59Type 2 diabetes mellitus with other circulatory complications
E13.59Other specified diabetes mellitus with other circulatory complications
