Ultrasound Question for the Week of October 10, 2016

Question:

Question:

Does the following code have to have all elements in the description imaged to make it a complete study?

93978 Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study

Some coders interpret the description to mean that all those vessels must be imaged, and that the “or bypass grafts” means that if there is a graft for one or more of the vessels then it should be imaged instead of the vessel(s) it replaced. Others say that it means a complete scan of the aorta or of the IVC or of the iliacs or of the graft(s).

Answer:

Answer:

Because the code description says “or,” you do not have to image all of the vessels listed in the description; “complete study” means that you image the entire vessel(s) selected However, you can report the code only once if you do image more than one of the listed vessels.

According to the American College of Radiology’s (ACR) 2016 Ultrasound Coding User’s Guide, code 93978 includes “duplex evaluation of the aorta, IVC, or iliac vessels or grafts involving these vessels. The code is the same whether one or more vessels are evaluated. The vessels investigated are studied in their entire intra-abdominal or pelvic course. For segmental investigation of a portion of the vessel, use 93979.”