How To Use CPT Code 93976

CPT 93976 refers to a duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents, and/or retroperitoneal organs in a limited study. This article will cover the description, procedure, qualifying circumstances, when to use the code, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 93976 procedures.

1. What is CPT 93976?

CPT 93976 is a medical procedure code used to describe a duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents, and/or retroperitoneal organs in a limited study. This diagnostic imaging technique is performed to examine the vascular supply to the organs involved and the venous return, providing valuable information for the diagnosis and treatment of various medical conditions.

2. 93976 CPT code description

The official description of CPT code 93976 is: “Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study.”

3. Procedure

1. The patient lies face up on an exam table.
2. A gel is applied to the skin over the abdominal, pelvic, scrotal, and retroperitoneal area to improve contact between the transducer and the skin and facilitate the transmission of sound waves.
3. A duplex ultrasound machine sends high-frequency sound waves through a probe, also called a transducer.
4. The transducer is pressed against the skin and moved over the area being studied.
5. The machine creates images of the structures in those areas, and a monitor displays the images.
6. The test usually takes about 30 minutes to complete.

4. Qualifying circumstances

Patients eligible to receive CPT code 93976 services are those who require a diagnostic evaluation of the arterial inflow and venous outflow of abdominal, pelvic, scrotal contents, and/or retroperitoneal organs. This may include individuals with suspected vascular abnormalities, such as arterial blockages, venous insufficiency, or blood clots. Additionally, patients with symptoms or medical conditions that may be related to vascular issues in these areas may also qualify for this procedure.

5. When to use CPT code 93976

It is appropriate to bill the 93976 CPT code when a limited duplex scan of the arterial inflow and venous outflow of abdominal, pelvic, scrotal contents, and/or retroperitoneal organs is performed. This code should be used when the study is focused on a single organ or a limited area within the specified regions, rather than a comprehensive evaluation of multiple organs or the entire region.

6. Documentation requirements

To support a claim for CPT 93976, the medical record must include full documentation of the anatomic and physiologic parameters examined during the procedure. This should also encompass a spectrum analysis and/or color flow mapping or imaging of the flowing blood. The documentation should clearly indicate the medical necessity for the limited study and provide sufficient detail to demonstrate the complexity and extent of the examination.

7. Billing guidelines

When billing for CPT code 93976, it is essential to follow the specific guidelines and rules established by the payer. This may include obtaining prior authorization, if required, and ensuring that the documentation submitted with the claim meets the payer’s requirements for medical necessity and completeness. Additionally, it is crucial to verify whether any modifiers or additional codes are necessary to accurately represent the services provided during the procedure.

8. Historical information

CPT 93976 was added to the Current Procedural Terminology system on January 1, 1992. There have been no significant updates to the code since its addition.

9. Similar codes to CPT 93976

There are several other codes related to duplex scans of various regions of the body. These codes differ from CPT 93976 in the specific areas examined and the extent of the study. Some examples include:

• CPT 93975: A comprehensive duplex scan of the abdominal, pelvic, scrotal contents, and/or retroperitoneal organs.
• CPT 93970: A complete bilateral duplex scan of the extremity veins, including the deep and superficial veins.
• CPT 93971: A unilateral or limited bilateral duplex scan of the extremity veins.
• CPT 93880: A complete bilateral duplex scan of the extracranial arteries, including the carotid and vertebral arteries.
• CPT 93882: A unilateral or limited bilateral duplex scan of the extracranial arteries.

10. Examples

1. A patient with suspected deep vein thrombosis in the pelvic region undergoes a limited duplex scan of the pelvic veins.
2. A patient with a history of abdominal aortic aneurysm has a limited duplex scan to monitor the arterial inflow to the abdominal organs.
3. A patient with unexplained scrotal pain undergoes a limited duplex scan of the scrotal contents to evaluate for possible vascular abnormalities.
4. A patient with a suspected renal artery stenosis has a limited duplex scan of the renal arteries to assess blood flow.
5. A patient with a history of liver transplant undergoes a limited duplex scan to evaluate the hepatic artery and portal vein blood flow.
6. A patient with chronic pelvic pain undergoes a limited duplex scan to assess for possible venous congestion in the pelvic region.
7. A patient with a suspected testicular torsion has a limited duplex scan of the scrotal contents to evaluate testicular blood flow.
8. A patient with a history of peripheral arterial disease undergoes a limited duplex scan to assess the arterial inflow to the lower extremities.
9. A patient with a suspected mesenteric ischemia has a limited duplex scan of the mesenteric arteries to evaluate blood flow to the intestines.
10. A patient with a history of renal transplant undergoes a limited duplex scan to assess the blood flow to the transplanted kidney.