Ultrasound Question for the Week of July 25, 2016

Question:

Question:

How should we code a noninvasive physiologic study of the lower extremity artery at rest and with exercise if the treadmill was not utilized? CPT code 93924 specifically states “following performance of a standardized protocol on a motorized treadmill.” Our vascular surgeon wanted the study performed, but the treadmill was not available and the patient was exercised by walking the hallway.

Answer:

Answer:

If a treadmill was not used, you just assign code 93922 or 93923 (once), depending on how many levels were evaluating and whether unilateral or bilateral.

93922 Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (e.g., for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus bidirectional, Doppler waveform recording and analysis at 1–2 levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus volume plethysmography at 1–2 levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries with, transcutaneous oxygen tension measurement at 1–2 levels)
93923 Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (e.g., for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental blood pressure measurements with bidirectional Doppler waveform recording and analysis, at 3 or more levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental volume plethysmography at 3 or more levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental transcutaneous oxygen tension measurements at 3 or more levels), or single level study with provocative functional maneuvers (e.g., measurements with postural provocative tests, or measurements with reactive hyperemia)