Cardiology Coding Alert

Watch for Your Chance to Report Duplex and ABI

Your payer's LCD may offer all the support you need.

When your cardiologist performs an extremity arterial physiologic study on the same date as an extremity duplex scan, you have to dig deep to be sure you're coding correctly.

Correct Coding Initiative (CCI) edits don't bundle 93922 and 93923 into duplex scan codes (93925-93931), but payers may not consider both services necessary unless the patient has specific diagnoses.

For example, Noridian's "Noninvasive Peripheral Arterial Studies" local coverage determination (L24339) states, "Duplex scanning and physiologic studies are reimbursed during the same encounter if the physiologic studies are abnormal and/or to evaluate vascular trauma, thromboembolic events or aneurysmal disease."

Reason: The equipment for the noninvasive physiologic studies is separate and distinct from the duplex scanner, as the CPT guidelines for Noninvasive Vascular Diagnostic Studies point out.

"Duplex" indicates that the cardiologist performed imaging. ABIs -- and all services 93922 and 93923 (Noninvasive physiologic studies ...) describe -- do notinvolve imaging.

Other Articles in this issue of

Cardiology Coding Alert

View All