Cracking the Code

Coding Noninvasive Vascular Diagnostic Studies

This type of testing is a painless examination to ascertain if there is any disease within the blood vessels. Noninvasive vascular diagnostic studies are reported for investigation of blood flow in the head, extremities, viscera, and penis. Examples of these studies include duplex scans and transcranial Doppler studies. Duplex scans are ultrasonic scanning procedures confirming patterns and direction of blood flow. The scan produces real-time, two-dimensional images of arteries and veins.

Cerebrovascular arterial studies evaluate right and left anterior and posterior circulation territories (including both the vertebral and basilar arteries) using ultrasound technology. If two or fewer territories are evaluated, report the code for a limited study.

Q: A patient visits his physician complaining of severe left lower leg pain and tingling. The left lower leg is pale compared to the right lower leg with no known injury. The doctor evaluates for a possible blood clot before considering any treatment. The doctor orders a duplex scan of the arteries of the left leg. The scan indicates no evidence of a clot. What is the correct CPT code for this service?
A: 93926. Rationale: In our CPT Index, we are going to look under Duplex Scan/Arterial Studies/Lower Extremity. We see CPT code 93926 is defined as a duplex scan, limited or unilateral study, of the lower extremity arteries, including digits. Pain and discoloration were present in the lower left leg, and the only extremity scanned.
Reference: FY 2023 CPT codebook
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