Radiology Coding Alert

But prepare for payers to scrutinize medical necessity. When your radiologist 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." You also have support from the American College of Radiology (ACR) in the July/August 2006 Coding Source, notes Stacie L. Buck, RHIA, CCS-P, LHRM, RCC, CIC, president and senior consultant of RadRx in Stuart, Fla. The Coding Source states that when the radiologists performs a [...]