Contractor Information
Contractor Name:
Highmark Medicare Services
Contractor Number:
12102, 12202, 12302, 12501, 12301, 12201
Contractor Type:
MAC Part A & B
Article Information
Article Database ID Number
A47800
Article Type
Article
Key Article
No
Article Title
Non-invasive Cerebrovascular Arterial Studies
Contractor’s Determination Number
A47800
Primary Geographic Jurisdiction
Pennsylvania, Maryland, District of Columbia, DELAWARE
Original Article Effective Date
07/11/2008
Article Revision Effective Date
08/01/2008
Article Ending Effective Date
N/A
Article Text
Coding Guidelines
The HCPCS/CPT code(s) may be subject to Correct Coding Initiative (CCI) edits. This information does not take precedence over CCI edits. Please refer to CCI for correct coding guidelines and specific applicable code combinations prior to billing Medicare.
When billing these procedures after a carotid endarterectomy, provide in the narrative the date of the surgery and the verbiage "carotid endarterectomy."
Do not report procedure codes 93890-93893 in conjunction with code 93888.
All non-invasive vascular study CPT codes are considered bilateral codes unless otherwise indicated in the CPT definition. The 150% payment adjustment for bilateral procedures does not apply. Modifier -50 and/or the anatomic modifiers, -LT/-RT should not be used.
Append the modifier –52 to report a unilateral study as appropriate. Information explaining the reduced service should be included in Item 19 of the CMS-1500 form or the electronic equivalent. Any appropriate documentation may be submitted with the claim to support the reduced service.
Coverage Topic
Diagnostic Tests and X-rays
Coding Information
CPT/HCPCS Codes
93875 | NONINVASIVE PHYSIOLOGIC STUDIES OF EXTRACRANIAL ARTERIES, COMPLETE BILATERAL STUDY (EG, PERIORBITAL FLOW DIRECTION WITH ARTERIAL COMPRESSION, OCULAR PNEUMOPLETHYSMOGRAPHY, DOPPLER ULTRASOUND SPECTRAL ANALYSIS) |
93880 | DUPLEX SCAN OF EXTRACRANIAL ARTERIES; COMPLETE BILATERAL STUDY |
93882 | DUPLEX SCAN OF EXTRACRANIAL ARTERIES; UNILATERAL OR LIMITED STUDY |
93886 | TRANSCRANIAL DOPPLER STUDY OF THE INTRACRANIAL ARTERIES; COMPLETE STUDY |
93888 | TRANSCRANIAL DOPPLER STUDY OF THE INTRACRANIAL ARTERIES; LIMITED STUDY |
93890 | TRANSCRANIAL DOPPLER STUDY OF THE INTRACRANIAL ARTERIES; VASOREACTIVITY STUDY |
93892 | TRANSCRANIAL DOPPLER STUDY OF THE INTRACRANIAL ARTERIES; EMBOLI DETECTION WITHOUT INTRAVENOUS MICROBUBBLE INJECTION |
93893 | TRANSCRANIAL DOPPLER STUDY OF THE INTRACRANIAL ARTERIES; EMBOLI DETECTION WITH INTRAVENOUS MICROBUBBLE INJECTION |
General Information
Other Comments
Refer to LCD L27504 for more information on noninvasive cerebrovascular arterial studies.
Revision History
Revision History Number
A47800
Revision History Explanation
| Date | Article # | Description |
|---|---|---|
08/01/2008 |
A47800 |
Article effective 08/01/2008 for DC Part A, Maryland Part A, and Pennsylvania Part A. Article is now effective for DC Part A and DCMA Part B; Maryland Part A and Maryland Part B; Pennsylvania Part A; and Delaware Part B. |
07/11/2008 |
A47800 |
Article release date. |