How To Use CPT Code 93986

CPT 93986 describes the non-invasive duplex scan of arterial inflow and venous outflow in one upper extremity for preoperative vessel assessment prior to the creation of hemodialysis access. 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 93986?

CPT 93986 can be used to describe a non-invasive duplex scan of the arteries and veins in one upper extremity. This scan is performed to assess the vascular supply and venous return in the arm before establishing hemodialysis access. It provides valuable information about the blood flow in the vessels of the upper extremities, helping healthcare professionals make informed decisions regarding the creation of hemodialysis access.

2. Official Description

The official description of CPT code 93986 is: ‘Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study.’

3. Procedure

1. The healthcare professional prepares the patient by having them lie face up on an exam table.
2. A gel is applied to the skin of the upper extremity being studied to improve contact between the transducer and the skin.
3. A duplex ultrasound machine is used to send high-frequency sound waves through a transducer, which is pressed against the skin and swept back and forth over the area being studied.
4. The transducer captures the sound waves reflected back and creates color-coded images of blood flow in the vessels of the upper extremity.
5. The healthcare professional uses these images to assess the speed, direction, and amount of blood flow in the arteries and veins of the arm.
6. The test usually takes about 30 minutes to complete.

4. Qualifying circumstances

CPT 93986 is typically performed on patients who require preoperative vessel assessment before the creation of hemodialysis access. It is used to evaluate the arterial inflow and venous outflow in one upper extremity. This procedure is necessary to determine the suitability of the vessels for hemodialysis access and to identify any potential issues that may affect the success of the procedure.

5. When to use CPT code 93986

CPT code 93986 should be used when a non-invasive duplex scan of the arterial inflow and venous outflow in one upper extremity is performed for preoperative vessel assessment prior to the creation of hemodialysis access. It is important to note that CPT code 93986 should not be reported in conjunction with codes 93926, 93931, 93971, or 93990 for the same extremity.

6. Documentation requirements

To support a claim for CPT code 93986, the healthcare professional must document the following information:

• Reason for the scan and the need for preoperative vessel assessment
• Date and time of the procedure
• Details of the upper extremity studied
• Findings of the duplex scan, including any abnormalities or issues identified
• Signature of the healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT code 93986, ensure that the procedure is performed on one upper extremity for preoperative vessel assessment prior to the creation of hemodialysis access. It is important to note that CPT code 93986 should not be reported with codes 93926, 93931, 93971, or 93990 for the same extremity. Additionally, it is recommended to review the specific guidelines provided by the payer to ensure accurate and appropriate billing.

8. Historical information

CPT code 93986 was added to the Current Procedural Terminology system on January 1, 2020. There have been no updates to the code since its addition.

9. Examples

1. A healthcare professional performs a non-invasive duplex scan of the arterial inflow and venous outflow in the right upper extremity of a patient to assess the vascular supply and venous return before creating hemodialysis access.
2. During a preoperative evaluation, a duplex scan of the arteries and veins in the left upper extremity is performed to assess the blood flow and identify any potential issues that may affect the success of hemodialysis access.
3. A patient with end-stage renal disease undergoes a non-invasive duplex scan of the arterial inflow and venous outflow in the right arm to evaluate the suitability of the vessels for hemodialysis access.
4. Prior to the creation of hemodialysis access, a healthcare professional performs a duplex scan of the arteries and veins in the left upper extremity to assess the blood flow and ensure optimal conditions for the procedure.
5. A non-invasive duplex scan of the arterial inflow and venous outflow in the right upper extremity is performed on a patient to evaluate the vascular supply and venous return before establishing hemodialysis access.
6. During a preoperative assessment, a healthcare professional conducts a duplex scan of the arteries and veins in the left arm to assess the blood flow and identify any potential issues that may impact the success of hemodialysis access.