Cardiology Coding Alert

Don't miss the changes to the number of levels required.

If you've been longing for more details in your noninvasive physiologic code definitions, you'll get your wish in 2011.

CPT Codes 2011 revises the definitions for CPT 93922-CPT 93924, explains Cheryl Schad, BA Ed, CPC, ACS-RA, PCS, president and CEO of Schad Medical Management in Mullica Hill, N.J. Check out how the 2010 and 2011 definitions compare for 93922-93924.

93922: Watch Changes to Number of Levels

When looking at the 93922 definitions, notice that the 2010 version refers to "single level," while the 2011 version offers several examples that refer to "1-2 levels":

2010: 93922 -- Noninvasive 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)

2011: 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 measurements at 1-2 levels).

93923: Number of Levels Are the Key Change Again

One of the changes to watch for 93923 is the switch from "multiple levels" in 2010 to "3 or more levels" in 2011:

2010: 93923 -- Noninvasive physiologic studies of upper or lower extremity arteries, multiple levels or with provocative functional maneuvers, complete bilateral study (e.g., segmental blood pressure measurements, segmental Doppler waveform analysis, segmental volume plethysmography, segmental transcutaneous oxygen tension measurements, measurements with postural provocative tests, measurements with reactive hyperemia)

2011: 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 level(s), or  single level study with provocative functional maneuvers (e.g., measurements with postural provocative tests, or measurements with reactive hyperemia).

93924: Improve Your Understanding of This Service

The change to 93924 is the addition of a lot more detail to explain what CPT intends the code to describe:

2010: 93924 -- Non-invasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, complete bilateral study

2011: 93924 -- Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (i.e., 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.