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2025 CPT code 93922

Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries using methods like ankle-brachial indices, Doppler waveform analysis, plethysmography, or transcutaneous oxygen tension measurements at 1-2 levels.

Follow CPT coding guidelines and payer-specific rules. Pay close attention to the distinction between limited (93922) and complete (93923) studies and appropriate modifier use.

Modifiers 51 (multiple procedures), 52 (reduced services), and 59 (distinct procedural service) may apply depending on the circumstances of the test and the service rendered.Always consult NCCI guidelines for correct modifier usage.

Medical necessity for 93922 is established by the presence of symptoms suggestive of peripheral arterial disease such as claudication, rest pain, non-healing wounds, or other clinical manifestations of compromised blood flow to the extremities.Pre-existing conditions like diabetes, hypertension, smoking, hyperlipidemia, etc., may also support medical necessity.

The physician or qualified healthcare professional performs the study, interprets the results, and documents the findings. The clinical responsibility includes selecting appropriate testing methods based on the patient's condition and medical history, performing the tests accurately, and analyzing the results to diagnose peripheral arterial disease.

IMPORTANT:Code 93923 is used for complete studies (3 or more levels) or studies with provocative maneuvers.If only one arm or leg is studied, use modifier 52. If both upper and lower extremities are studied, use modifier 59 on the second code.

In simple words: This test checks blood flow in the arteries of your arms or legs without using imaging. It measures blood pressure and flow at one or two points to see if there are any blockages. Several methods are used, such as special pressure measurements, Doppler ultrasound, or oxygen level tests.

This CPT code encompasses a limited bilateral noninvasive physiologic evaluation of the arteries in either the upper or lower extremities.The assessment involves measurements at one to two levels and may utilize one of the following: ankle-brachial indices at the distal posterior tibial and anterior tibial/dorsalis pedis arteries combined with bidirectional Doppler waveform recording and analysis; ankle-brachial indices along with volume plethysmography at one to two levels; or ankle-brachial indices in conjunction with transcutaneous oxygen tension measurements at one to two levels.Possible measurement sites include the high thigh, low thigh, calf, ankle, metatarsal, and toes (lower extremity) or the arm, forearm, wrist, and digits (upper extremity).The procedure does not involve imaging techniques.

Example 1: A patient presents with intermittent claudication (leg pain with exertion). A 93922 is performed on the lower extremities to assess the degree and location of arterial blockage., A diabetic patient with a non-healing foot ulcer undergoes a 93922 to evaluate for peripheral arterial disease affecting wound healing.The test is focused on the lower extremity., A patient with suspected upper extremity arterial disease due to numbness and cold sensations in their fingers undergoes a 93922 which is performed bilaterally on both arms to assess blood flow.

Detailed documentation should include patient demographics, reason for the study, specific sites of measurement, values obtained for each measurement (ankle-brachial indices, Doppler waveforms, plethysmography, or transcutaneous oxygen tension), interpretation of results, and a summary of findings that support the medical necessity of the procedure.This should be documented in the patient's medical record.

** The use of a simple handheld Doppler device without hard copy output or bidirectional flow analysis is considered part of the physical exam and isn't separately billable.Always cross-reference with payer-specific guidelines and local coverage determinations to ensure accurate reimbursement.

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