How To Use CPT Code 93926

CPT-93926 is an ultrasound duplex scan performed unilaterally, or as part of a limited examination. This article will cover CPT 93926 procedure descriptions, procedures, conditions that qualify, documentation requirements, billing guides, historical information and similar codes.

1. What is CPT 93926

CPT-93926 is the medical billing code for a duplex sonogram of lower extremity arterial grafts or arteries performed unilaterally, or as a restricted study. This noninvasive diagnostic method is used to determine the rate of blood circulation and assess whether there are any blockages in the lower limb arteries.

2. 93926 CPT code description

The official CPT 93926 description is: “Duplex study of the lower extremities arteries or arterial by-pass grafts. Unilateral or limited studies.”

3. It is a procedure to be followed

1. The patient lies flat on an examination table.
2. The provider applies a special gel to the part of the leg under study to improve contact with the transducer. This helps the sound waves better penetrate the skin.
3. The provider presses and sweeps the transducer over the desired area.
4. Doppler waveform studies can now be enhanced with the addition of a duplex scanner.
5. The test takes approximately 30 minutes.

4. The qualifying circumstances

CPT service 93926 may be provided to patients who exhibit symptoms or have medical histories that indicate the presence of lower-extremity arterial disease. These patients may have peripheral artery diseases, claudications or ulcers that do not heal. They could also have a history arterial bypass graft. The duplex can also be used as a tool to monitor progress in treatment or evaluate the patency if a bypass.

5. CPT code 9326:

When a provider performs a duplex ultrasonography scan of lower extremity arteries, or arterial bypasses, unilaterally, or as part of a limited examination, in order to evaluate blood flow and detect blockages, it is appropriate to use the CPT code 93926. This code should only be used in cases where the patient’s symptoms or medical history suggests that there is a lower extremity blockage or arterial disease. It can also be used to monitor treatment and graft viability.

6. Documentation is required

In order to prove a claim under CPT 93926 the following documentation should be presented:

• Patients’ medical history and symptoms indicate the need to perform a duplex scanner.
• Physical examination findings relating to the lower extremity arterial system.
• Details of duplex scan procedures, including side of body being examined and specific areas of concern.
• Results of the duplex scanner, including any abnormalities identified or blocked arteries.
• Providers can interpret the findings of the duplex scanner.
• You will receive any recommendations regarding further testing, treatments, or care following the duplex results.

7. Billing guidelines

To ensure the correct billing of CPT code 93926, it is necessary to make sure that the documentation supports that the procedure was medically necessary and that all the conditions are met by the patient. Avoid incorrect billing by being aware of codes that are similar and their differences. CPT93926 and CPT93986 are not the same code.

8. Historical information

CPT 93926 became part of the Current Procedural terminology system on 1 January 1992. Since its addition in 1992, there have not been any updates.

9. CPT 93926 and other codes similar to CPT

Five codes similar to CPT-93926 and their differentiation are:

• CPT 9392: Single-level, noninvasive physiologic studies on the upper and lower extremities, bilateral.
• CPT 93923. Noninvasive physiologic investigations of upper and lower extremity arteries. Multiple levels or functional maneuvers are used. Complete bilateral study.
• CPT 9925: Duplex scanning of lower extremity arterial grafts, or arterial bypass; bilateral study.
• CPT 9390: Complete bilateral study on upper extremity arteries, arterial bypass grafts and duplex scan.
• CPT 093931: Duplex study of upper extremity arterial grafts or arteries; unilateral or restricted study.

10. The following are examples of how to use

Here are ten detailed examples of CPT 93926 procedure:

1. A patient with an underlying peripheral artery condition presents with a worsening of claudication on the left leg. The provider uses a CPT-93926 dual scan to evaluate the left lower extremity’s arteries.
2. A patient who has a non-healing foot ulcer undergoes CPT 93926 to measure the blood flow within the right lower extremity.
3. A patient with an antecedent history of arterial bypass in the left limb experiences new-onset leg pain. The provider performs CPT-93926 Duplex Scan to assess the patency.
4. A patient with diabetes who has peripheral artery disease receives a CPT-93926 dual scan to monitor arterial disease progression in the lower right extremity.
5. A patient with intermittent left-leg claudication due to smoking is scanned using the CPT 93926 Duplex Scan. This scan evaluates the left lower extremity for blockage.
6. CPT-93926 duplex scanning is used on a patient known to have an abdominal aortic rupture. This scan measures the blood circulation in the lower extremity left arteries.
7. A patient with an underlying history of deep venous thrombosis (DVT) and leg swelling is given a CPT-93926 dual scan to check for arterial involvement in the right lower extremity.
8. CPT-93926 duplex scanning is performed to check for arterial abnormalities on the lower extremities of the left leg.
9. The CPT-93926 duplex scanner is used on a patient with a past history of leg pain when exercising and hypertension to determine if the lower extremity right arteries are blocked.
10. CPT-93926 duplex scanning is used on a right lower extremity patient with an intermittent claudication, and a previous history of hyperlipidemia.