Duplex vs Doppler vs Non-Vascular
Billing a duplex code w/o documentation of color and spectral is wrong. Guidelines clearly state in the CPT, by AMA, AHIMA & RBMA, & RAD Avocate color and spectral are required.
Based on the example above 93971 would not be appropriate.
Doppler is a very different NON imaging study that duplex or non-vascular US and would not be appropriate either for a doppler study w/o color or spectral if measures, ABI etc are not done.
Since this question is from 2007 the guidelines have been updated yet many coders still refer to these forums and this would be incorrect guidance.
All sources have affirmed that documentation of the assessment of flow with color, recording a spectral waveform, and a report of the findings should all be present in the report in order to assign a Duplex CPT code.* If this documentation is not in the report, a non-vascular ultrasound code should be assigned, representing a decrease in reimbursement.** See code descriptions and reimbursements below.
The following documentation would support assigning a Duplex CPT code:
?Duplex scan of the body site performed using B-Mode/gray scale imaging and Doppler spectral analysis and color flow?.
Without the proper documentation:
? 93975/93976 $89/$60: Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; (Complete/Limited) would be down coded to ? 76705 $29:* Limited abdominal US
? 93970/93971 $35/$22 :* Duplex scan of extremity veins including responses to compression and other maneuvers; (Bilateral/Unilateral) would be down coded to 76882 $24 :* Limited extremity US
? 93925/93926 $40/$25 :* Duplex scan of lower extremity arteries or arterial bypass grafts; (Bilateral/Unilateral) would be down coded to 76882 $24:* Limited extremity US
? 93880/93882 $29/$21:* Duplex scan of extracranial arteries; (Bilateral/Unilateral) would be down coded to ? 76536 $28* Head/neck soft tissue US