CPT code 93923 describes a non-invasive evaluation of blood flow and upper or lower extremities blockages.
What Is CPT Code 93923?
CPT 93923 is used for a non-invasive evaluation of blood flow and blockages in the upper or lower extremities using multiple levels of pneumatic cuffs, Doppler waveform recording and analysis, volume plethysmography, or transcutaneous oxygen tension measurements.
Provocative functional maneuvers may also be included in the examination. This procedure is used to identify blockages or strictures in the arteries with a high level of precision.
The CPT book describes CPT code 93923 as: “Complete bilateral non-invasive physiologic studies of upper or lower extremity arteries, three or more levels (e.g., for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental blood pressure measurements with bidirectional Doppler waveform recording and analysis, at three or more levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental volume plethysmography at three or more levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental transcutaneous oxygen tension measurements at three or more levels), or single level study with provocative functional maneuvers (e.g., measurements with postural provocative tests, or measurements with reactive hyperemia).”
Segmental pressure measurement is one of the essential examinations a physician may perform to evaluate blood flow patterns and blockage in the arms and legs.
During this process, the physician places two or three pneumatic blood pressure cuffs on the arms or legs at various levels (proximal thigh, distal thigh, foot, ankle, calf, etc.).
The cuffs are inflated above the average systolic blood pressure and deflated slowly. Blood pressure measurements are taken using a Doppler instrument.
Volume changes in the upper and lower extremity segment below the cuff are translated into pulsatile pressure, which is detected by a transducer and displayed as a pressure pulse contour.
Several functional maneuvers are also performed for a complete bilateral study. A high–level drop in pressure between two adjacent cuffs indicates the presence of a blockage or stricture inside the artery at that part of the extremity.
The precision rate of identifying a blockage in an artery via this process is relatively high (almost 97%).
How To Use CPT 93923
CPT code 93923 is bilateral. Therefore, do not append modifier 50 when this procedure is performed bilaterally.
Bill CPT 93923 once for lower extremity(s) and/or once in the upper extremity(s). You can report this code twice if you add modifier 59 to the second procedure.
Report CPT code 93922 instead of CPT 93923 when only one arm or leg is available for study.
You may use CPT 0631T for transcutaneous visible light hyperspectral imaging measurement of oxyhemoglobin, deoxyhemoglobin, and tissue oxygenation.