Date: 5/22/2018
According to the Centers for Medicare & Medicaid Services (CMS), it is rarely necessary to perform extremity venous studies (CPT codes 93970-93971) and arterial studies (CPT codes 93922-93931) during the same session. Therefore, both the venous studies and arterial studies will be denied when billed without a supporting diagnosis for either study.
If both types of studies are performed during the same encounter without a supporting diagnosis for the arterial study, the arterial study will be denied.
Examples of supporting diagnoses for the arterial study:
- Atherosclerosis (ICD-10 diagnosis codes I70.0-I70.1, I70.21-I70.399, I70.41-I70.499, I70.51-I70.599, I70.61-I70.699, I70.71-I70.799)
- Angina pectoris (ICD-10 diagnosis codes I20.0-I20.8)
- Non-pressure chronic ulcer (ICD-10 diagnosis codes L97-L97.929)
- Injury of blood vessels at shoulder and upper arm (ICD-10 diagnosis codes S45-S45.999S)
- Injury of blood vessels at ankle and foot (ICD-10 diagnosis codes S95-S95.999S)
- Complications of internal prosthetic devices, implants and grafts (ICD-10 diagnosis codes T85.8-T85.9XXS)
If both types of studies are performed during the same encounter without a supporting diagnosis for the venous study, the venous study will be denied.
Examples of supporting diagnoses for the venous study:
- Thrombophilia (ICD-10 diagnosis codes D68.5-D68.69)
- Angina pectoris (ICD-10 diagnosis codes I20.0-I20.8)
- ST elevation (STEMI) and non-ST elevation (NSTEMI) myocardial infarction (ICD-10 diagnosis codes I21-I22.9)
- Atherosclerosis (ICD-10 diagnosis codes I70.0-I70.1, I70.21-I70.399, I70.41-I70.499, I70.51-I70.599, I70.61-I70.699, I70.71-I70.799)
- Intra-abdominal and pelvic swelling, mass and lump (ICD-10 diagnosis codes R19.0-R19.09)
- Injury of iliac blood vessels (ICD-10 diagnosis codes S35.50-S35.516S)
