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Neurology & Pain Management Coding Alert

Reader Question:

Transcranial Dopplers With Carotid Ultrasounds

Published on Sat Sep 01, 2001

Question: We have been receiving denials from Medicare when we bill transcranial dopplers with carotid ultrasounds. Is this correct?

Missouri Subscriber  
Answer: Yes, this is correct. According to Medicare, it is not medically necessary to perform more than one type of physiological study in the same anatomic area.
 
Cerebrovascular arterial studies (93880-93888) are used to evaluate vascular blood flow in relation to blockage. A duplex scan includes a real-time scan. Therefore, billing for both a duplex scan and echography of the same body part is unbundling and is not allowed.
 
When an uninterpretable study necessitates that another type of study be performed, only the successful study should be billed. 
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