2025 CPT code 93978
(Active) Effective Date: N/A Revision Date: N/A Diagnostic - Non-Invasive Vascular Diagnostic Studies Medicine Services and Procedures Feed
Complete duplex scan of the aorta, inferior vena cava, iliac vasculature, or bypass grafts.
Modifiers 26 (professional component) and TC (technical component) may be used separately, depending on who performs each part of the service.Other modifiers may be applicable based on the circumstances of the service.Refer to the CPT manual for detailed modifier usage.
Medical necessity is typically established by the presence of symptoms (e.g., abdominal pain, leg swelling, claudication) suggestive of vascular disease, or the need for post-operative graft surveillance.Documentation should support the clinical indication for the study.
The physician or qualified healthcare professional is responsible for performing the ultrasound examination, interpreting the results, and documenting findings in the patient's chart.
In simple words: This test uses ultrasound to create detailed pictures of major blood vessels in your abdomen and pelvis (aorta, vena cava, and iliac arteries). The doctor looks for blockages, aneurysms (bulges in the blood vessel), or problems with blood flow. It helps check the health of these blood vessels or how well a bypass graft is working.
This CPT code represents a comprehensive duplex Doppler ultrasound examination of the aorta, inferior vena cava (IVC), iliac vasculature, or bypass grafts.The study involves a complete assessment of the targeted vascular structures, encompassing both anatomical imaging and physiological flow analysis using real-time images, spectral Doppler, and color flow Doppler techniques.This examination aims to evaluate for vascular abnormalities, patency of grafts, or follow up on previously placed bypass grafts.The procedure includes image acquisition, analysis of bidirectional blood flow, and interpretation of the results with documentation for patient records.
Example 1: A patient presents with abdominal pain and a suspected abdominal aortic aneurysm (AAA). A complete duplex scan (93978) is performed to evaluate the aorta and iliac arteries for aneurysmal dilation or occlusion., Post-operative follow up of an aorto-iliac bypass graft. A complete duplex scan (93978) is performed to assess the patency and hemodynamics of the graft., A patient presents with lower extremity edema and suspected deep vein thrombosis (DVT) involving the iliac veins and inferior vena cava. A complete duplex scan (93978) is performed to evaluate the IVC and iliac veins for thrombus formation.
Detailed report including images, waveforms, measurements of vessel diameter, flow velocities (with directionality), and an interpretation of the findings.Documentation should specify the vessels examined, the extent of the study, and any identified abnormalities.
** Accurate coding of 93978 relies heavily on complete and accurate documentation, including the specific vessels studied, the extent of the study (complete vs. limited), and the findings.Incomplete documentation may lead to claim denials or underpayment.
- Revenue Code: I3F (ECHOGRAPHY - OTHER)
- RVU: Professional (-26):Variable based on location and payer; Technical (-TC): Variable based on location and payer.See specific payer fee schedules for current reimbursement rates. Global payment may also apply. Example: Medicare reimbursement may include a professional component of approximately $31.98 and a technical component of approximately $154.74 (DRA capped).
- Global Days: Global period varies by payer and may be included in the overall payment. Check payer specific guidelines.
- Payment Status: Active
- Modifier TC rule: Modifier TC is used to identify the technical component of the procedure. This will be reported separately from the professional component.
- Fee Schedule: Fee schedules vary significantly by payer and geographic location. Consult payer-specific fee schedules for historical and current reimbursement data.Note that DRA capped rates are frequently applied.
- Specialties:Vascular Surgery, Cardiology, Radiology, Interventional Radiology
- Place of Service:Office, Hospital (Inpatient and Outpatient), Ambulatory Surgical Center