CPT code 93971 refers to a Duplex scan for a unilateral or limited study. It includes responses to compression and other maneuvers. Below we explain how you should report 93971 appropriately.
Duplex scanning arteries to measure blood flow is a noninvasive vascular diagnostic method. Peripheral vascular flow patterns can be studied using real-time ultrasound imaging and pulsed Doppler.
As a result of this treatment, it is possible to determine whether or not there are any obstructed or stenotic veins in the arteries.
Suppose an upper and lower extremity complete or partial bilateral study is performed. The appropriate code can be reported once (i.e., once for the upper and lower extremities).
Description Of CPT Code 93971
CPT code 93971 is a study that can be used for both a limited bilateral and a limited unilateral service since it is unilateral or limited in scope.
CPT code 93971 should be used to document either a partial or full unilateral duplex scan study. Only one service has to be reported. Using the 50 modifier with CPT code 93971 for a limited bilateral trial is not permissible.
The official description of CPT 93971 is: “Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study.”
It is necessary to know how many vessels were photographed, whether the service is bilateral, and whether the deep and superficial systems were examined for reporting purposes.
To paraphrase the saying, “The golden rule is to perform only what is necessary and report only what you have done.”
Two-dimensional structure and motion, time and Doppler ultrasonic signal recording, spectral analysis, and color flow velocity mapping or imaging are some functions that a duplex scan can perform.
An independent piece of equipment is used for noninvasive physiologic examinations rather than duplex scanners. Besides pressure measurements, a complete extremities physiologic assessment may include Doppler ultrasound or plethysmography.
All deep veins in the leg, including the gastrocnemius, anterior and posterior tibia, and the standard and deep femoral veins, are examined for a complete evaluation. Afterward, the superficial veins, including the sacroiliac, perforating, and tributary veins, are evaluated.
A full-duplex scanning test for CVD should include visibility, deformability, and vascular flow, assessing the duration of regurgitation, enhancement, physicality, and vein size.
A cutoff value of 500 milliseconds is set for the saphenous, tibial, deep, and perforating veins, whereas the femoral and popliteal veins have a cutoff of one second.”The study must be documented with 93971 if even one item is absent or not addressed in the interpretation, leading to medical need
CPT code 93971 should be used for a restricted bilateral or complete unilateral study (only one service should be reported). Using a 50 modifier with CPT 93971 for a limited bilateral study.
It is not just unilateral vs. bilateral that separates codes 93970 and 93971. Reporting on 93970 must meet the strict definition of comprehensive bilateral research. It is possible to use research code 93971 for both a limited bilateral and a unilateral application.
Both 93970 and CPT code 93971, a duplex scan of the extremities veins, can be used for a complete or partial assessment.
To bill for the EVAT’s accompanying extremity venous duplex imaging (93970–93971), a modifier must be applied to the EVAT’s accompanying diagnostic extremity Doppler ultrasound (93970–93971)
It is necessary to bill 93970 and CPT code 93971 twice, depending on whether the upper or lower extremities have venous duplex scans.
For example, reporting 93970 for the left arm and right leg images would be incorrect. Please report CPT code 93971 twice in this case. The modifier -59 (distinct procedural service) must specify that the second code is for a different body location.
The 59 modifiers distinguish between the RVU CPT code 93971 and the procedure code 93970. If the exam was prepared at a different level and is not covered by bilateral exam number 93970, the modifier will help determine if the exam is eligible for reimbursement.
When describing a “complete bilateral study,” CPT code 93970 is commonly used. According to CPT code 93971, a “single or limited” study. When conducting a bilateral study, you can use 93970 and 93971; 93970 for comprehensive research and 93971 for more limited research.
Suppose the upper and lower extremities undergo a complete or partial bilateral investigation. Then, the appropriate code should only be entered once (i.e., once for the upper extremities and once for the lower extremities).
A different provider’s medical examination repeat service should be attached to the second code to show two separate, unique studies were completed. In addition, a written report or interpretation should be generated for each study.
The following is a billing example when CPT code 93971 may be used:
Suppose the doctor will do a Duplex scan on the right leg’s extremities to identify the discomfort’s source. After doing the test, the doctor concludes that there are no anomalies in the veins.
We will code the signs and symptoms as the primary diagnosis in compliance with outpatient coding regulations because no precise diagnosis has been made.
Because of this, the scenario will record right leg edema as the primary diagnosis, with operation CPT code 93971 – RT.