2025 CPT code 93998
(Active) Effective Date: N/A Medicine Services and Procedures - Non-Invasive Vascular Diagnostic Studies Medicine Feed
Unlisted noninvasive vascular diagnostic study. This code is used for noninvasive vascular diagnostic procedures or services that do not have a specific CPT code.
Modifiers may be applicable to further specify the circumstances of the procedure. Refer to current CPT guidelines for appropriate modifier usage.
Medical necessity must be clearly documented. The documentation must support the reason for performing the study, relating the symptoms and clinical findings to the need for the specific test. Because the code is "unlisted", additional information is required to demonstrate the procedure performed provided clinically significant information not obtainable through other available coded services.
The physician is responsible for performing the noninvasive vascular diagnostic procedure or service. This includes patient preparation, conducting the test, interpreting the results, and documenting the findings in the patient's medical record. When using this unlisted code, the physician should provide clear documentation to justify the medical necessity of the procedure and why a listed code isn't applicable.
In simple words: This code is used when a doctor performs a test on your blood vessels without needles or incisions, and there's no specific code for the exact test they did. It might be for a new or unusual test. For example, if a doctor does a test on your blood vessels without measuring the ankle-brachial index (ABI), which compares blood pressure in your ankle and arm, this code might be used.
This code is used to report noninvasive vascular diagnostic procedures or services that are not described by other specific CPT codes. It encompasses procedures or services like venous studies that don't have a dedicated code.It is applicable for new, rare, or unusual noninvasive vascular procedures. One example of its use is when a noninvasive vascular test is performed without an ankle-brachial index (ABI), as ABIs are required for codes 93922, 93923, and 93924.
Example 1: A patient presents with unusual varicose veins that don’t fit the typical presentation for venous insufficiency. The physician performs a novel noninvasive vascular diagnostic study to assess blood flow in the affected veins, which doesn’t have a designated CPT code, necessitating the use of 93998. , A patient with a history of peripheral artery disease undergoes a noninvasive vascular diagnostic study using a new technology not yet recognized by CPT codes. The study involves measuring blood flow and oxygen saturation in the lower extremities with a new device, and the physician reports 93998 due to the absence of a specific code., A patient presents with suspected thoracic outlet syndrome, and the physician performs a noninvasive vascular diagnostic study that combines different measurements, including blood pressure, pulse wave velocity, and transcutaneous oxygen tension at various levels of the upper extremities. As this combination of measurements isn't covered by any specific CPT code, 93998 is used.
Documentation should support the medical necessity of the procedure, detailed description of the procedure performed, the results, and an explanation of why a specific code wasn’t applicable. The documentation must justify the use of the unlisted code 93998 by clearly describing the unique nature of the procedure or service provided. Compare and contrast the performed procedure with similar, listed procedures to show why those codes weren't appropriate.Include any relevant images, tracings, or other data obtained during the study. A detailed operative report should be submitted with the claim to provide comprehensive information about the procedure.
- Revenue Code: T2D - OTHER TESTS - OTHER
- Payment Status: Active
- Specialties:Vascular surgery, cardiology, interventional radiology, or other specialties involved in vascular diagnosis. The specific specialty will depend on the exact nature of the unlisted noninvasive vascular diagnostic study performed.
- Place of Service:Office, Outpatient Hospital, or other facility where such studies are performed. The place of service will depend on the specific equipment and resources required for the particular study being performed.