Wiki 93922 vs 93923 unilateral vs bilateral modifier?

[dmccullers]

We perform LEAs in our office daily. We will do this studies after a pt has intervention and sometime the LEA is only performed on 1 leg. After reviewing the CPT codes once again I feel like I need clarification.

93922- Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries (for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus bidirectional, doppler waverform recording and analysis at 1-2 levels

93923- Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries. 3 or more levels (for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus bidirectional, doppler waverform recording and analysis at 3 levels or more

We are doing the description of 93923, but only on one leg. Do we bill 93922 or 93923? The Bilateral is what is throwing us off. Or is there a modifier we need to add??? Modifier 52????

 

[mfronk]

52

Hey there, I believe you would attach the 52 modifier on 93923 if it is done unilateral to specify reduced services. Hope that helps!

 

[CodingKing]

I'd go with what the parenthetical note states, 93922-52 if unilateral 1-2 levels or 93922 (no mod) if unilateral 3+ levels.

Looks like it would make more sense if AMA changed it from 2 codes to 4 codes. Sounds like they don't want you to take a reduction as long as 3+ levels are done unilaterally.