93880 CPT Code, cpt 93880, 93880 cpt, cpt code 93880, 93880

93880 CPT Code (2022) – Description, Guidelines, Reimbursement, Modifiers & Examples

The 93880 CPT code narrates the duplex scan of extracranial arteries and defines it as a complete bilateral study.

CPT code 93880 is used to evaluate blood flow is a non-invasive vascular diagnostic study. The provider can selectively visualize blood flow patterns in arteries using real-time ultrasound imaging.

Ultrasound of high-frequency sound waves produces real-time blood flow imaging in major arteries. Duplex scan of extracranial study is a diagnostic study used to measure various anatomical aspects of carotid arteries.

The vascular tests are performed to examine blood flow in arteries and veins. These tests are non-invasive, and thus no needles are used in this procedure.

93880 CPT Code Description

The 93880 CPT code is used for duplex ultrasound is a specialized explanation of ultrasound waves and a necessary test for today’s medical diagnosis. 

93880 CPT Code Description
93880 CPT Code Description

Duplex ultrasonography syndicates anatomic and flow ultrasonography ideologies and provides analytical data to the benefactor.

Doppler ultrasonography is referred to as identifying flow or movement inside the tissue with the help of the Doppler effect. Therefore, it is imperative to have a basic understanding of the technology, and one must also know the basic principles for complete comprehension. 

Duplex ultrasound works as a combination of conventional ultrasound, color flow Doppler imaging, and spectral Doppler analysis. 

Usually, CPT code 93880 is submitted as complete bilateral or limited, i.e., unilateral. The unilateral study or limited study may depend on the place or position of vessels.

The extracranial duplex procedure is not painful, but the patient may feel discomfort during the procedure. The technologist will use all possible comfort measures to fulfill the procedure. Patients do not need any special care after the duplex procedure.

Duplex scanning is a high-frequency ultrasound wave used to diagnose arteries and veins’ blood pattern and direction. The non-invasive vascular diagnostic procedure comprises duplex scanning, which evaluates blood flow in arteries and veins. 

While duplex scan of cerebrovascular arteries (CPT 93880) is a comparatively safe and widely available modality, it has its specific shortcomings and indications. 

To get a quality study requires the interchange of numerous aspects, and there are conventional principles that are significant to ponder to certify reliability, interpretability, and meaningful results. 

The complete ultrasound of cerebrovascular structures is two-sided. If a particular indication requires a limited study, then the reduced services can be utilized.

Duplex scanning of extracranial arteries (CPT code 93880) is used to diagnose the presence of any occlusion or arterial stenosis and to identify the vein with reduced functionality.

While performing the 93880 CPT code procedure (duplex scanning of extracranial arteries), it is vital to have a basic knowledge of ultrasound technology to perform and interpret duplex ultrasounds effectively. 

This activity analyses all aspects, for example, all of the indications, possible contraindications, and the advantages of ultrasound in medical practice. Thus, it is indicative and outlines the role of the skilled team in patients’ care.

While performing the CPT code 93880 (duplex scanning of extracranial arteries), some basic processes must be followed. 

No preparation is required for the 93880 CPT code procedure. The patient should bring a referral to complete the test on the test day. The patients should not carry any jewelry or any valuable item. 

The 93880 CPT Code Procedure

Before performing the 93880 CPT code procedure, a highly qualified technologist explains the details of the procedure. Then, they may apply the gel to the whole neck of the patient. 

A transducer will be placed over various locations on the neck. The waves (sound waves) are then bounced off in the patients’ body.

Next, the echoes are reflected in the transducer, and after that, all these resonances (echoes) are transformed into signals (electrical).

Unusual sound waves are heard as the technician views the flow of blood in the arteries. The result may take approx. 20 – 40 min.

There are no post-exam instructions after performing CPT code 93880. The result reports are then studied by a specialist (vascular ultrasound specialist), and all of the outcomes are directed to the physician. 

Common Indications CPT Code 93880

The 93880 CPT code has many advantages over other imaging methods, including being non-invasive, complete, and well accepted. However, as a matter of concern, it is not automatic and always requires a technician or operator, so there may be some delays in results. 

The avascular study may be done to check signs and symptoms that mean you have decreased blood flow in arteries in the neck, legs, or arms. Health problems may cause decreased blood flow in extracranial arteries. 

Duplex ultrasound (CPT 93880) is the choice for diagnosing cerebrovascular disease.

There may be other reasons for the provider to recommend CPT code 93880. Atherosclerosis is a slow clogging of the arteries over many years by fatty materials/plaque) and other substances in the bloodstream.

A thrombus or embolus is a blood clot that forms in a blood vessel is a thrombus.

Billing Guidelines For The 93880 CPT Code

For evaluation of carotid arteries, use CPT code 93880 for duplex scan of extracranial arteries and complete bilateral study.

Duplex scan of extracranial arteries; complete bilateral study there are few medical documentation requirements needed to get the reimbursement.

The medical record documentation must support the medical necessity of the services as directed as per CMS (Center for Medicaid and Medicare Services) guidelines.

Suppose multiple procedures are performed with a duplex study (CPT code 93880). In that case, the medical necessity for performing both non-invasive extracranial arterial studies (CPT 93880) and non-invasive evaluation of extremity veins (CPT 93970) during the same encounter must be documented in the medical record. 

The 93880 CPT code should be billed only by a relevant specialty doctor because the covering companies do not reimburse the claim if any other provider does not execute the duplex scan.

Therefore, only cardiologists, neurologists, radiologists, or vascular surgeons can submit this CPT to insurance for reimbursement. CPT code 93880 is denied when performed by a provider specialty other than Vascular Surgeon, Cardiologist, Neurologist, and/or Radiologist.

As per medically unlikely edits adjudication, indicator three dates of service and more than one unit are allowed to bill on the same date of service

93880 CPT Code Reimbursement

While coding duplex scan of extracranial study (CPT code93880) procedures, selecting the correct code is essential because reimbursement depends on code selection. 

93880 CPT code reimbursement for the duplex scan’s national physician fee schedule (PFS) facility is $199.3, and Non-facility PFS is $199.3. Therefore, incorrect selection of CPT affects the claim payment may be underpayment or overpayment.

While reviewing the medical documentation coder must keep in mind the use of ICD 10 CM codes specific to the duplex study as per LCD (local coverage determination). Coder is responsible for the submission of accurate claims.

While reviewing the medical documentation coder keep in mind to select the correct codes to get the reimbursement.

Accurate coding of duplex study is a key for claim processing that includes proper selection of CPT code, diagnosis code, and modifier when necessary.

Extracranial duplex study (93880 CPT code) requires a highly qualified technologist. Due to this, CPT code 93880 under technician NPI is higher than the physician payment. Payment of CPT 93880 under physician NPI is $42, and compensation under technician NPI is $187.5.

Modifiers For CPT Code 93880

The 93880 CPT code represents a bilateral study. Therefore, modifier 50 and/or the anatomic modifier LT and RT should not be used. 

Carotid arteries are available on both sides of the neck. Therefore, all non-invasive vascular study CPT codes are reflected bilateral codes unless otherwise indicated in the CPT definition. 

Modifier 59 is a payment entitlement modifier used to signify distinct procedural services. Modifier 59 is used when multiple procedures are performed in the same setting, and more than one procedure is allowed to bill on the same day.

Still, the modifier is required to distinguish two separate procedures. Whenever multiple procedures performed in the same setting and coding guidelines are allowed to bill together, the modifier is required, so 59 modifiers must be appended with column 2 CPT code.

The addition of modifier 59 is eligible for the payment of two procedures. If modifier 59 is not in the claim, insurance may pay procedure having lower RVU (relative value unit) and denied procedure having higher RVU (relative value unit).

Hence, getting the payment of multiple procedure modifier 59 is necessary for reimbursement. 

Use modifier 76 if the provider needs to bill the 93880 (duplex study extracranial study) more than once on the same date of service. 

Modifier 76 is for repeat procedures by the same provider on the same date of service. Modifier 77 is used with Duplex study extracranial study (CPT code 93880) when different providers need to bill duplex study at the same date of service. 

Modifier 53 is used when due to some complication, a procedure is terminated.

Modifier 22 is valid with extracranial duplex study bilateral (93880 CPT Code) whenever the provider takes more time to complete the procedure due to any complication, so modifier 22 must be used.

Suppose a provider performs extracranial duplex study bilateral (93880) and extracranial duplex study of unilateral or limited study in the same date of service.

As per CMS guidelines, these two procedures are not allowed to bill on the same date of service.

In this case, as per coding guidelines, proceed with CPT code 93880 due to higher relative value unit and remove the 93882 because it is a unilateral or limited study. Therefore, payment of CPT 93882 is included in this code. 

Example 1

A 55 years old female came to the provider’s office presenting a complaint of carotid artery stenosis (greater than 60%), having numbness or weakness in the face, sudden loss of balance, and severe headache.

Provider decided to go for a duplex extracranial scanning bilateral study to confirm the current status of patient health.

In the above example provider decided on a duplex extracranial scanning bilateral study (93880). ICD 10 CM code used with CPT 93880 is i65.23. 

Example 2:

A sixty-five-year-old obese male patient came to the provider’s office with complaints of dizziness, confusion, headache, and temporary blindness in one eye. 

These symptoms may be the early warning of a stroke. Provider suggests a duplex extracranial scanning bilateral study to diagnose the patient’s condition.

In this case, the provider decided to go for a duplex extracranial scanning bilateral (93880). After the study, the final diagnosis is a cerebral infarction (i63.89) to justify the procedure’s medical necessity.

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