TMPPM 2010 > Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook > Physician > Procedures and Services > Doppler Studies

   
 

6.3.21 Doppler Studies

A doppler examination is a noninvasive procedure that detects blood flow velocity within an artery or vein. It is commonly used to detect stenosis or occlusion of an artery or vein.

Doppler studies include the patient care required to perform the studies, supervision and the interpretation of study results.

Doppler studies of the extracranial arteries (procedure codes 93875, 93880, and 93882) are limited to the following diagnosis codes:

Diagnosis Code

33701

36230

36231

36232

36233

36234

36284

36811

36812

3682

36840

36841

36842

36843

36844

36845

36846

36847

43310

43311

43320

43321

43330

43331

4351

4352

4353

4358

4359

436

44100

44281

44321

44323

44329

44589

449

7802

7843

78451

78459

78552

7859

90000

90001

90002

90003

9961

Transcranial doppler studies of the intracranial arteries (procedure codes 93886, 93888, 93890, 93892, and 93893) are limited to the following diagnosis codes:

Diagnosis Codes

34830

34831

34839

34881

34889

430

43400

43401

43410

43411

43490

4351

4352

4353

4358

4359

4370

4430

44381

4439

4471

449

74781

74782

74783

74789

78552

Doppler studies of the upper and lower extremity arteries (procedure codes 93922, 93923, 93924, 93925, 93926, 93930, and 93931) are limited to the following diagnosis codes (unless otherwise indicated):

Diagnosis Codes

4404

4439

4440

4441

44421

44422

44481

44489

44501*

44502**

4466

4467

4470

449

60782

60784

70710

70711

70712

70713

70714

70715

70719

7854

78552

90300

90301

9031

9032

9033

9034

9035

9038

9039

9040

9041

90440

90441

90450

90451

90453

92300

92301

92302

92303

92309

92310

92311

92320

92321

9233

9238

9239

92400

92401

92410

92411

92420

92421

9243

9244

9245

9248

9249

92700

92701

92702

92703

92709

92710

92711

92720

92721

9273

9278

9279

92800

92801

92810

92811

92820

92821

9283

9288

9289

9961

99690

99691

99692

99693

99694

99695

99696

99699

* Diagnosis code 44501 may be billed with procedure codes 93922, 93923, 93930, and 93931 only.
** Diagnosis code 44502 may be billed with procedure codes 93922, 93923, 93924, 93925, and 93926 only.

Doppler studies of the extremity veins (procedure codes 93965, 93970, and 93971) are limited to the following diagnosis codes:

Diagnosis Codes

4510

45111

45119

4512

45181

45182

45183

45184

45189

4519

4530

4531

4532

4533

45340

45341

45342

4539

4548

45350

45351

45352

4536

45371

45372

45373

45374

45375

45376

45377

45379

45381

45382

45383

45384

45385

45386

45387

45389

45910

45911

45912

45913

45919

60784

70710

70711

70712

70713

70714

70715

70719

7823

78552

90300

90302

9033

9034

9035

9038

9039

9042

9043

90440

90442

90450

90452

90454

9046

9047

9048

9049

92700

92701

92702

92703

92709

92710

92711

92720

92721

9273

9278

9279

92800

92801

92810

92811

92820

92821

9283

9288

9289

9961

99690

99691

99692

99693

99694

99695

99696

99699

9972

Doppler echocardiography color flow velocity mapping (procedure code 93325) is limited to the following diagnosis codes:

Diagnosis Codes

3911

3940

3941

3942

3949

3950

3951

3952

3959

3960

3961

3962

3963

3968

3969

3970

3971

3979

39890

41406

41407

41411

4150

4160

4168

4178

4210

42290

42291

4240

4241

4242

4243

42490

42491

42499

4251

4253

4254

4259

4280

7450

74510

74511

74512

7452

7453

7454

7455

74560

74561

74569

74600

74601

74602

74609

7461

7462

7463

7464

7465

7466

7467

74681

74682

74683

74685

7470

74710

74711

74722

7473

74741

74742

74749

7852

78552

9607

9961

99771

99772

99779

V433

Multiple doppler procedures (for example, studies of extra-cranial arteries and intracranial arteries) billed on the same day are reimbursed at full fee for the first, and half for each additional study regardless of the number of services billed.

Procedure codes described as complete bilateral studies are inclusive codes. Right and left studies submitted with the same date of service are considered for reimbursement as a quantity of one.

Procedure codes 93882, 93888, 93926, 93931, 93971, 93976, and 93979 are considered unilateral codes. Right and left studies are reimbursed at full and one-half fee.

Procedure code 93325 may be considered for reimbursement separately from transthoracic and transesophageal echocardiograph procedure codes 93312 and 93350, when billed with the same date of service by the same provider.


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