Wiki Need Help - 93925 arterial duplex documentation

[niharims]

CPT-93925

Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study
Notes:
(Do not report 93925 in conjunction with 93985 for the same extremities)

If at all there is a Medicare or other insurance audit what all things should be there for 93925 arterial duplex?

Apart from demographics and DOS;

1. It should be bilateral
2. right and left data of velocities, stenosis, phasicity of major arteries of LL
3. waveforms interpreted into findings for both left and right
4. conclusion

However, my question is, Is it mandatory to mention the indication in the report itself?


Please, review the attached report , if it is containing sufficient information to survive the insurance Audit?
I could find one mistake , that it doesn't contain the indication as why the procedure was done.
Please advise.

 

[ccollison]

If you don't have the indication for doing the test, where's your medical necessity? I would send this back to the provider for correction/additional info.

C Collison, CPC, CCC, CPMA, CPPM

 

[niharims]

If you don't have the indication for doing the test, where's your medical necessity? I would send this back to the provider for correction/additional info.

C Collison, CPC, CCC, CPMA, CPPM

Thank you very much for the guidance. However, Provider would like to get some insurance document requesting same or reference material.
It would be a great help if you can provide the same.

 

[ccollison]

I thought a bit more about this. What is the indication/dx on the order for the test? Why not add that info on the test?
C Collison

 

[ccollison]

look up Medicare policy L35761