2025 CPT code 93990
(Active) Effective Date: N/A Revision Date: N/A Diagnostic - Non-Invasive Extremity Arterial-Venous Studies Medicine Services and Procedures > Non-Invasive Vascular Diagnostic Studies Feed
Duplex scan of hemodialysis access, including arterial inflow, body of access, and venous outflow.
Modifiers may apply depending on the circumstances of the service provided. For example, modifier 26 (professional component) may be used if the physician only interprets the study and doesn't perform it. Modifiers 59 (distinct procedural service) or TC (technical component) might be used under specific scenarios.
Medical necessity for this procedure is typically established by clinical symptoms or findings suggesting compromised hemodialysis access, such as decreased dialysis flow rate, thrill or bruit changes, or signs of occlusion. Preoperative assessment and postoperative surveillance are also valid indications.
The physician or qualified healthcare professional performs the duplex ultrasound examination, interpreting the results and documenting findings.This involves assessing vessel patency, blood flow characteristics, and identifying any potential complications like stenosis, thrombosis, or aneurysms.
- Medicine Services and Procedures > Non-Invasive Vascular Diagnostic Studies
- Medicine Services and Procedures > Non-Invasive Vascular Diagnostic Studies > Non-Invasive Extremity Arterial-Venous Studies
In simple words: This test uses ultrasound to check the blood vessels used for dialysis. It looks at how well blood flows through the access point (like a fistula or graft) to make sure it's working correctly.
This CPT code 93990 represents a duplex ultrasound scan of a hemodialysis access site, encompassing a comprehensive evaluation of the arterial inflow, the access site itself (e.g., arteriovenous fistula or graft), and the venous outflow.The procedure utilizes ultrasound technology to visualize and analyze blood flow patterns, vessel structure, and potential abnormalities within the hemodialysis access.Detailed assessment includes parameters such as vessel diameter, wall thickness, flow velocity, presence of stenosis, thrombosis, or other complications.
Example 1: A patient with an arteriovenous fistula for hemodialysis experiences decreased dialysis access flow. A duplex ultrasound (93990) is performed to assess the patency and flow characteristics of the fistula, revealing a stenosis requiring intervention., Preoperative assessment of a planned arteriovenous graft for hemodialysis.A duplex ultrasound (93990) is performed to evaluate the suitability of the chosen vessels and identify any potential issues that could compromise graft function., Postoperative evaluation of a hemodialysis graft. A duplex ultrasound (93990) is used to detect any complications such as thrombosis or stenosis, guiding subsequent management and interventions.
* Detailed patient history including dialysis access type and any related symptoms.* Pre-procedure images if available.* Ultrasound images showing arterial inflow, body of access, and venous outflow.* Measurements of vessel diameter, wall thickness, flow velocity, and any abnormalities.* Physician interpretation and report including diagnosis, and recommendations.
** Always refer to the most current CPT codebook and payer guidelines for accurate coding and reimbursement information.Specific documentation requirements may vary based on payer policies and local coverage determinations (LCDs).
- Revenue Code: P9A (Dialysis Services - Medicare Fee Schedule)
- RVU: This information is not available in the provided text. Refer to the current CPT codebook or a relevant fee schedule for RVU values.
- Global Days: Not applicable.This is a diagnostic procedure, not a surgical procedure with a global period.
- Payment Status: Active
- Modifier TC rule: Modifier TC may apply if only the technical component of the procedure is performed; however, the professional component is usually bundled into the code.
- Fee Schedule: Historical fee schedule data is not available in the provided text and varies by payer.Consult payer-specific fee schedules or relevant databases for historical payment information.
- Specialties:Vascular Surgery, Nephrology, Interventional Radiology
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center