Cerebrovascular Arterial Studies (93880-93893)
93880 Duplex scan of extracranial arteries; complete bilateral study
93882 Duplex scan of extracranial arteries; unilateral or limited study
(To report common carotid intima-media thickness (IMT) study for evaluation of atherosclerotic burden or coronary heart disease risk factor assessment, use Category III code 0126T)
Cerebrovascular Arterial Studies (93880-93893)
A complete TCD study (93886) includes: – right and left anterior circulation and the posterior circulation (to include vertebral and basilar arteries).
A limited TCD study (93888) includes: – evaluation of two or fewer of these territories.
For TCD, evaluation is a reasonable and concerted attempt to identify arterial signals through an acoustic window.
Cerebrovascular Arterial Studies (93880-93893)
93886 Transcranial Doppler study of the intracranial arteries; complete study
93888 Transcranial Doppler study of the intracranial arteries; limited study
Cerebrovascular Arterial Studies
93895 Quantitative carotid intima media thickness and carotid atheroma evaluation, bilateral
(Do not report 93895 in conjunction with 93880, 93882, 0126T)
Group 1 Paragraph: Extracranial Arteries Studies (93880-93882)
Use a diagnosis code of R22.1 (localized swelling, mass, and lump, neck) to report pulsatile neck mass. Use a diagnosis code of H93.11, H93.12, or H93.13 to report pulsatile tinnitus. Use a diagnosis code of R09.89 (Other specified symptoms and signs involving the circulatory and respiratory systems) to report a carotid bruit.
Coverage Policy
Duplex scan to evaluate for carotid artery stenosis is considered medically necessary for ANY of the following indications:
• disorders of the carotid artery
• new or worsening neurologic symptoms, including stroke (i.e., cerebrovascular attack [CVA]), transient ischemic attack (TIA), amaurosis fugax
• unilateral motor or sensory deficit, and speech impairment
• altered level of consciousness
• dementia
• seizures
• carotid bruit
preoperative evaluation for cardiovascular or carotid surgical procedures
• evaluation of the carotid arteries in an individual with a history of carotid disease
• suspected carotid artery dissection, fistula, or pseudoaneurysm
• malignancy of the carotid body
• migraine headache
• retinal vein or artery occlusion and hemorrhage
• myocardial infarction
• coronary artery disease
• atrial fibrillation and atrial flutter
• intracranial infarction and hemorrhage
• dissection of the carotid and thoracic artery
Screening for carotid artery stenosis by duplex scan in an asymptomatic individual is considered not medically necessary.
Covered ICD-10-CM Codes Description
C75.4 Malignant neoplasm of carotid body
D35.5 Benign neoplasm of carotid body
D44.6 Neoplasm of uncertain behavior of carotid body
E08.311- E08.319 Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy
E08.3211-E08.3213 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema
E08.3291-E08.3293 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema
E08.3311-E08.3313 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema
E08.3391- E08.3393 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema
E08.3411-E08.3413 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema
E08.3491- E08.3493 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema
E08.3511-E08.3513 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema
E08.3521- E08.3523 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula
E08.3531- E08.3533 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula
E08.3541- E08.3543 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment
E08.3551- E08.3553 Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy
E08.3591- E08.3593 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema
E08.37X1- E08.37X3 Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment
E08.39 Diabetes mellitus due to underlying condition with other diabetic ophthalmic complication
E08.51-E08.59 Diabetes mellitus due to underlying condition with circulatory complications
E09.311-E09.319 Drug or chemical induced diabetes mellitus with unspecified diabetic retinopathy
E09.3211- E09.3213 Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema
E09.3291-E09.3293 Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema
E09.3311- E09.3313 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema
E09.3391-E09.3393 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema
E09.3411- E09.3413 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema
E09.3491- E09.3493 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema
E09.3511- E09.3513 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with macular edema
E09.3521- E09.3523 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula
E09.3531- E09.3533 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula
E09.3541- E09.3543 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment
E09.3551- E09.3553 Drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy
E09.3591- E09.3593 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy without macular edema
E09.37X1- E09.37X3 Drug or chemical induced diabetes mellitus with diabetic macular edema, resolved following treatment
E09.39 Drug or chemical induced diabetes mellitus with other diabetic ophthalmic complication
E09.51- E09.59 Drug or chemical induced diabetes mellitus with circulatory complications
E10.311- E10.319 Type 1 diabetes mellitus with unspecified diabetic retinopathy
E10.3211-E10.3213 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema
