A: When a duplex Doppler of the lower extremities is performed with the addition of ankle/brachial (A/B) indices, it is appropriate to code 93925 (Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study) for the duplex scan and 93922 (Noninvasive physiologic studies of upper or lower extremity arteries, single level, bilateral (eg, ankle/brachial indices, Doppler waveform analysis, volume plethysmography, transcutaneous oxygen tension measurement) for the A/B indices.
Code 93922 is for a limited noninvasive physiologic arterial study that covers one level only of each leg (eg, ankle brachial indices with ankle waveforms).1 It is not appropriate to code 93922 in conjunction with 93923 (Noninvasive physiologic studies of upper or lower extremity arteries, multiple levels or with provocative functional maneuvers, complete bilateral study (eg, segmental blood pressure measurements, segmental Doppler waveform analysis, segmental volume plethsmography, segmental transcutaneous oxygen tension measurements, measurements with postural provocative tests, measurements with reactive hyperemia) as 93922 is a limited version of 93923. Code 93923 includes segmental pressures and tracings and is used to report bilateral complex noninvasive physiologic testing procedures.
Duplex scanning (such as 93925) describes an ultrasonic scanning procedure for characterizing the pattern and direction of blood flow in the arteries in a single display of real time images integrating 2-D vascular structure with spectral and color flow Doppler mapping or imaging.
As noted in the CPT 2006 codebook, the noninvasive physiologic studies are performed using equipment separate and distinct from the duplex scanner. Codes 93875, 93965, 93922, 93923, and 93924 describe the evaluation of nonimaging physiologic recordings such as ankle/brachial indices, Doppler analysis of bidirectional blood flow, plethysmography, and/or oxygen tension measurements appropriate for the anatomic area studied.