How To Use CPT Code 93931

CPT 93931 describes the non-invasive diagnostic procedure of a duplex scan of the upper extremity arteries or arterial bypass grafts on one side. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 93931?

CPT 93931 is used to describe a non-invasive diagnostic procedure called a duplex scan. This procedure involves the use of ultrasound to examine the upper extremity arteries or arterial bypass grafts on one side of the body. The purpose of this scan is to assess the rate of blood flow and identify any blockages in the arteries.

2. Official Description

The official description of CPT code 93931 is: ‘Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study.’ It is important to note that this code should not be reported in conjunction with CPT codes 93985 and 93986 for the same extremity.

3. Procedure

1. During the procedure, the patient lies on an exam table.
2. The healthcare provider applies a gel to the area of the arm being studied to improve contact between the transducer and the skin.
3. The provider then presses the ultrasound transducer firmly against the skin and sweeps it back and forth over the area to be examined.
4. This process allows the provider to visualize the blood vessels and assess the rate of blood flow.
5. A duplex scan combines traditional ultrasound with Doppler ultrasound, which measures the speed and other aspects of blood flow.
6. The test usually takes about 30 minutes to complete.

4. Qualifying circumstances

CPT 93931 is performed on patients who require a non-invasive assessment of their upper extremity arteries or arterial bypass grafts. This procedure is typically ordered for patients who may have symptoms or risk factors for arterial blockages, such as pain, numbness, or a history of vascular disease. It is important to note that this code should not be reported for both sides of the body simultaneously.

5. When to use CPT code 93931

CPT code 93931 should be used when a healthcare provider performs a duplex scan of the upper extremity arteries or arterial bypass grafts on one side of the body. This code is appropriate for a unilateral or limited study. If the provider needs to perform a complete study or assess both sides of the body, a different CPT code should be used.

6. Documentation requirements

To support a claim for CPT 93931, the healthcare provider must document the following information:

• Reason for the procedure and the medical necessity
• Specific details of the duplex scan, including the side of the body studied
• Date and duration of the procedure
• Findings of the scan, including any abnormalities or blockages
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 93931, ensure that the procedure is performed on one side of the body and is not reported in conjunction with CPT codes 93985 and 93986 for the same extremity. It is important to review the documentation and coding options in the range of codes 93922 to 93931 to accurately report the procedure based on the specific circumstances and diagnosis code.

8. Historical information

CPT 93931 was added to the Current Procedural Terminology system on January 1, 1992. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient with symptoms of arm pain undergoes a duplex scan of their upper extremity arteries to assess for blockages.
2. A patient who has undergone a coronary artery bypass graft on one side of their body receives a duplex scan to evaluate the graft’s patency.
3. A patient with a history of vascular disease undergoes a duplex scan of their arterial bypass grafts to monitor for any signs of blockages.
4. A patient with numbness in their hand undergoes a duplex scan of their upper extremity arteries to assess blood flow and identify any potential causes of the symptoms.
5. A patient with risk factors for arterial disease, such as smoking and diabetes, undergoes a duplex scan of their upper extremity arteries as part of a routine screening.
6. A patient with a history of trauma to their arm undergoes a duplex scan to assess for any vascular damage or blockages.
7. A patient with a suspected arterial blockage in their arm undergoes a duplex scan to confirm the diagnosis and determine the appropriate treatment.
8. A patient with a history of arterial bypass graft surgery undergoes a duplex scan to monitor the graft’s function and detect any potential complications.
9. A patient with a known arterial blockage in their arm undergoes a duplex scan to assess the severity of the blockage and plan for potential interventions.
10. A patient with symptoms of poor circulation in their arm undergoes a duplex scan to evaluate the blood flow and identify any potential causes of the symptoms.