How To Use CPT Code 93978

CPT 93978 is a code used for a complete duplex scan of the aorta, inferior vena cava, iliac vasculature, or bypass grafts. 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 93978 procedures.

1. What is CPT 93978?

CPT 93978 is a medical code used to describe a complete duplex scan of the aorta, inferior vena cava, iliac vasculature, or bypass grafts. This diagnostic procedure is performed using duplex Doppler ultrasound scanning to assess any vascular abnormalities in these structures or to follow up on previously placed bypass grafts.

2. 93978 CPT code description

The official description of CPT code 93978 is: “Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study.”

3. Procedure

The 93978 CPT code procedure involves the following steps:

1. The patient lies face up on an exam table.
2. A gel is applied to the skin over the area being studied to facilitate the transmission of sound waves.
3. A duplex ultrasound machine sends high-frequency sound waves through a probe, referred to as a transducer.
4. The transducer is pressed against the skin and moved over the area being studied.
5. The machine creates images of the aorta, the inferior vena cava, iliac vasculature, or bypass grafts.
6. A monitor displays the images for the practitioner to analyze.
7. The test usually takes about 30 minutes to complete.

4. Qualifying circumstances

Patients eligible to receive CPT code 93978 services are those who have a clinical indication for the study, such as:

• Suspected or known vascular abnormalities in the aorta, inferior vena cava, iliac vasculature, or bypass grafts.
• Follow-up evaluation of previously placed bypass grafts.
• Assessment of blood flow and vessel patency in the studied structures.
• Monitoring of known vascular conditions or post-surgical outcomes.

5. When to use CPT code 93978

It is appropriate to bill the 93978 CPT code when a complete duplex scan of the aorta, inferior vena cava, iliac vasculature, or bypass grafts is performed for diagnostic purposes or follow-up evaluation. The procedure should be medically necessary and supported by the patient’s clinical presentation and medical history.

6. Documentation requirements

Proper documentation is essential to support a claim for CPT 93978. The medical record should include:

• A detailed description of the anatomic and physiologic parameters studied.
• Spectrum analysis and/or color flow mapping or imaging of the flowing blood.
• Indication for the study and its relevance to the patient’s clinical condition.
• Findings, measurements, and any identified abnormalities.
• Interpretation and clinical impression of the study by the practitioner.

7. Billing guidelines

When billing for CPT code 93978, it is essential to follow the appropriate guidelines and rules. Some tips include:

• Ensure that the procedure is medically necessary and supported by the patient’s clinical presentation and medical history.
• Verify that the documentation meets the requirements for CPT 93978.
• Check for any payer-specific guidelines or policies related to CPT 93978.
• Be aware of any bundling or modifier rules that may apply to CPT 93978.

8. Historical information

CPT 93978 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 93978

There are several codes similar to CPT 93978, which differ based on the specific structures studied and the extent of the examination. These include:

• CPT 93975: A duplex scan of the arterial inflow and venous outflow of the abdominal, pelvic, scrotal contents, and/or retroperitoneal organs.
• CPT 93976: A limited study of the arterial inflow and venous outflow of the abdominal, pelvic, scrotal contents, and/or retroperitoneal organs.
• CPT 93979: A duplex scan of the aorta, inferior vena cava, iliac vasculature, or bypass grafts, but limited to a single vessel or graft.
• CPT 93980: A duplex scan of the penile vessels, including arterial inflow and venous outflow.
• CPT 93981: A limited study of the penile vessels, focusing on either arterial inflow or venous outflow.

10. Examples

Here are ten detailed examples of CPT code 93978 procedures:

1. A patient with a history of abdominal aortic aneurysm undergoes a complete duplex scan of the aorta to monitor the aneurysm’s size and stability.
2. A patient with suspected iliac artery stenosis undergoes a complete duplex scan of the iliac vasculature to assess blood flow and vessel patency.
3. A patient with a known inferior vena cava thrombosis undergoes a complete duplex scan of the inferior vena cava to evaluate the thrombus and venous flow.
4. A patient with a history of aortoiliac bypass grafting undergoes a complete duplex scan of the bypass grafts to assess graft patency and blood flow.
5. A patient with unexplained lower extremity swelling undergoes a complete duplex scan of the iliac vasculature to evaluate for venous insufficiency or obstruction.
6. A patient with a history of aortic dissection undergoes a complete duplex scan of the aorta to monitor the dissection’s progression and stability.
7. A patient with suspected renal artery stenosis undergoes a complete duplex scan of the aorta and renal arteries to assess blood flow and vessel patency.
8. A patient with a history of deep vein thrombosis undergoes a complete duplex scan of the inferior vena cava and iliac veins to evaluate for recurrent thrombosis.
9. A patient with a known abdominal aortic aneurysm undergoes a complete duplex scan of the aorta before and after endovascular repair to assess the aneurysm’s exclusion and blood flow.
10. A patient with a history of peripheral artery disease undergoes a complete duplex scan of the aortoiliac vasculature to evaluate for disease progression and blood flow.