CPT 93970 describes the non-invasive procedure of duplex scan of extremity veins, including responses to compression and other maneuvers. 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 93970?
CPT 93970 can be used to describe a non-invasive procedure called a duplex scan of extremity veins. This procedure involves using ultrasound technology to assess the pattern and direction of blood flow in the veins of the arms or legs. The provider will also perform maneuvers, such as compression, to observe changes in the flow inside the veins. This is a complete, bilateral study that provides valuable information about the patient’s vascular health.
2. Official Description
The official description of CPT code 93970 is: ‘Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study. Do not report 93970 in conjunction with 93985, 93986 for the same extremity[ies].’ This code specifically refers to a comprehensive evaluation of the extremity veins using ultrasound technology, including the assessment of blood flow responses to compression and other maneuvers.
- The provider begins by applying a gel to the patient’s skin at the areas to be tested.
- Using an ultrasound probe (transducer), the provider moves it over the skin of the patient’s arms or legs.
- The probe emits sound waves that travel into the body and reflect back as echoes when they encounter soft tissue.
- A computer converts the sound wave data into real-time images, allowing the provider to visualize the vascular structure.
- The duplex scan combines conventional ultrasound imaging (B-mode) with Doppler ultrasound, which detects the movement of blood cells and provides information about blood flow.
- The provider may perform maneuvers, such as compression using blood pressure cuffs, to observe changes in the flow inside the veins.
- The provider documents the images and interpretation of the results.
4. Qualifying circumstances
CPT 93970 is typically performed on patients who require an evaluation of their extremity veins. This procedure is commonly used to assess patients with suspected venous insufficiency, deep vein thrombosis, or other vascular conditions. It is important to note that CPT 93970 should not be reported in conjunction with CPT codes 93985 or 93986 for the same extremity or extremities.
5. When to use CPT code 93970
CPT code 93970 should be used when a comprehensive evaluation of the extremity veins is required. This includes assessing the pattern and direction of blood flow, as well as the responses to compression and other maneuvers. It is important to ensure that the provider performs a complete bilateral study to accurately report this code.
6. Documentation requirements
To support a claim for CPT 93970, the provider must document the following information:
- Reason for the procedure and the medical necessity
- Specific findings from the duplex scan, including any abnormalities or areas of concern
- Details of the maneuvers performed, such as compression and their impact on blood flow
- Date and time of the procedure
- Images obtained during the scan, if applicable
- Interpretation of the results and any recommendations for further evaluation or treatment
7. Billing guidelines
When billing for CPT 93970, it is important to follow the appropriate guidelines. If only the professional component of the service is being reported, append modifier 26 to the code. If only the technical component is being reported, append modifier TC. However, it is important to note that payer policies may exempt hospitals from appending modifier TC, as the hospital’s portion is inherently technical. If both the professional and technical components are rendered by the same provider, do not append any modifiers. It is also important to avoid reporting CPT 93970 in conjunction with CPT codes 93985 or 93986 for the same extremity or extremities.
8. Historical information
CPT 93970 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.
- A patient presents with symptoms of leg swelling and pain. The provider performs a duplex scan of the extremity veins to assess for deep vein thrombosis.
- A patient with a history of varicose veins undergoes a duplex scan of the extremity veins to evaluate the venous insufficiency.
- A patient with a suspected blood clot in the arm undergoes a duplex scan of the extremity veins to assess for thrombosis.
- A patient with chronic leg ulcers undergoes a duplex scan of the extremity veins to evaluate the venous circulation.
- A patient with a history of peripheral artery disease undergoes a duplex scan of the extremity veins to assess the blood flow in the arteries and veins.
- A patient with a suspected venous malformation undergoes a duplex scan of the extremity veins to evaluate the vascular anatomy.
- A patient with a suspected venous stenosis undergoes a duplex scan of the extremity veins to assess the blood flow and identify any narrowing in the veins.
- A patient with a history of deep vein thrombosis undergoes a duplex scan of the extremity veins to monitor the patency of the veins and assess for any recurrent clotting.
- A patient with chronic leg pain and swelling undergoes a duplex scan of the extremity veins to evaluate for venous insufficiency.