Cardiology Coding Alert

Question: I'm confused by the 2011 guidelines for 93922-93923. When should I report 93922-52?

Answer: You should report 93922-52 (Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries ... 1-2 levels; Reduced services) when the patient has only one limb available for study and the physician records only one or two levels.

Example: A patient has had his right leg amputated. The physician performs the study on two levels on the patient's left leg. You should report this unilateral, limited service using 93922-52.

The source of the confusion may be that CPT guidelines for 93922 and for 93923 (Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels ...) instruct you to report limited code 93922 when the physician performs a unilateral exam for three or more levels, or using provocative functional maneuvers, on a patient with only one arm or leg available for study.

In other words: That means 93922 (without modifier 52) is appropriate for:

• A bilateral exam on one or two levels
• A unilateral exam on three or more levels (that is, lower and/or upper extremity amputee)
• A unilateral exam when performing provocative functional maneuvers.

Experts recommend the following list to help you count levels:

Lower Extremity Levels        Upper Extremity Levels