In simple words: This procedure uses ultrasound to create images of the blood flow in the arteries and veins of one arm or leg. This helps doctors check blood circulation before a dialysis access procedure.

This code describes a complete duplex ultrasound scan of both the arterial and venous systems of a single upper or lower extremity to assess vascular flow before creating a hemodialysis access point. The procedure includes the evaluation of arterial inflow and venous outflow and involves real-time imaging, integrating B-mode two-dimensional vascular structure, Doppler spectral analysis, and color flow Doppler imaging.It is important to note that this code should not be reported in conjunction with other specific arterial or venous duplex scans (93926, 93931, 93971, 93990) for the same extremity.

Example 1: A patient with end-stage renal disease requires the creation of an arteriovenous fistula for hemodialysis. A preoperative duplex scan of the non-dominant arm is performed using code 93986 to assess the suitability of the vessels., A patient with chronic kidney disease is being evaluated for hemodialysis access. A complete unilateral duplex scan of the left leg is performed (93986) to determine if the leg veins are suitable for access placement., A patient with kidney failure requires a hemodialysis access. The physician performs a duplex scan of the right arm (93986) to check arterial inflow and venous outflow before creating a fistula.

Documentation should include details about the patient's medical history, the reason for the scan (preoperative assessment for hemodialysis access), the extremity examined (unilateral), the findings of the duplex scan, including the quality of arterial inflow and venous outflow, and the interpretation of the results.