Cpt code 93880 & 93882 for Carotid Doppler Coding tips

Introduction : Cpt Code 93880 & 93882 for carotid Doppler

In radiology, Cpt code for Carotid doppler is very frequently coded. The codes for carotid Doppler are very few. Only two CPT codes are used for carotid Doppler. Cpt code for Carotid doppler has very simple non-invasive arterial ultrasound procedure. Now, there are two CPT Codes used for carotid Doppler. The exam is performed to find any diagnosis or disorder present in carotid artery. Carotid arteries are present in the neck region. Cpt Code 93880 & 93882 for carotid Doppler is easy to code if we know the procedure. Now, let us check out the codes used for carotid Doppler.

To bill for a Limited Duplex Scan, the dictation must at least include: Color and Spectral Doppler

To bill for a Complete Duplex Scan, the dictation must include: Arterial inflow & Venous Outflow and Color & Spectral Doppler

Cpt code 93880 & 93882 for Carotid Doppler

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Description of Cpt Code 93880 & 93882

The codes used for carotid Doppler are 93880 and 93882. Both codes are used for coding in radiology facility. The only difference between the two codes is the Bilateral (93880) and Unilateral (93882) examination of carotid arteries. So, the code description for both codes is as below

93880 – Duplex scan of extracranial arteries; complete bilateral study
93882 – Duplex scan of extracranial arteries; unilateral or limited study

 

The very commonly used CPT code for carotid Doppler is 93880 when the exam is performed on both carotid arteries. The exam is performed to find any occlusion or stenosis present in the carotid arteries of neck.

 

Procedure cost for CPT code 93880 and 93882

Professional component (93880-26)-$40.91

Technical component (93880-TC)- $164

In Hospital setting  – $205.64

Professional component (93882-26)-$25

Technical component (93882-TC)- $105

In Hospital setting – $131

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Extracranial Arterial Studies (93880 – 93882)

Covered cerebrovascular arterial study testing methods include (real-time) duplex scans; and Doppler ultrasound waveform with spectral analysis.

Non-covered/non-reimbursed methods include testing methods that have not been found to be useful based on authoritative technological assessments or that are included as part of the physical examination.

Indications:

Cerebrovascular arterial studies may be considered medically necessary if one or more of the following signs and symptoms are present:

  • Asymptomatic or symptomatic cervical bruits;
  • Amaurosis fugax;
  • Focal cerebral or ocular transient ischemic attacks (including but not limited to):
    • localizing symptoms, e.g., sensory loss; and/or
    • weakness of one side of the face; and/or
    • slurred speech; and/or
    • weakness of a limb;
  • Syncope that is strongly suggestive of vertebrobasilar or bilateral carotid artery disease in etiology, as suggested by medical history;
  • Recent history of a previous neurologic or cerebrovascular event;
  • Before major cardiac and vascular surgery when a bruit is noted or there is a history of previous neurologic or cerebrovascular event;
  • After carotid endarterectomy (outside the global period), or follow-up of previously documented stenoses;
  • Pulsatile neck mass;
  • Evaluation of blunt or penetrating neck trauma;
  • Ocular microembolism (optic nerve/retinal arterial-Hollenhorst plaques/ocular);

Limitations: Studies may not be considered medically necessary if performed for the following signs and symptoms:

  • Drop attack or syncope are rare indications usually seen with vertebrobasilar or bilateral carotid artery disease.
  • Dizziness is not a typical indication unless associated with other localizing signs or symptoms. However, episodic dizziness with symptom characteristics typical of transient ischemic attacks may indicate medical necessity, especially when other more common sources, e.g., postural hypotension or transiently decreased cardiac output as demonstrated by cardiac event monitoring, have been previously excluded; and/or
  • Headaches (including migraines).

Diagnosis related to CPT code 93880 &  93882 for Carotid Doppler

The signs and symptoms related to carotid Doppler are like dizziness, syncope, numbness etc. However, the final diagnosis to find through this exam is stenosis. So, the main purpose to perform to carotid Doppler is to find stenosis or obstruction present in carotid arteries. The stenosis is measured and documented in percentage (%) to know to exact occlusion present in the carotid arteries. So, let us check out common diagnosis related to CPT code for carotid Doppler

               

Stroke
Cerebral Infarction
Occlusion of Carotid artery
Stenosis of Carotid Artery with/without Cerebral Infarction

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PQRS related 93880 & 93882 CPT code for Carotid Doppler

The PQRS coded with CPT code for Carotid Doppler is Category II CPT Code 3100F. This PQRS comes under Measure 195. There are certain things to check to code 3100F with 8P or without 8P, let checkout them.

CPT II 3100F: Carotid Doppler ultrasound study report should document direct or indirect reference to measurements of distal internal carotid diameter as the denominator for stenosis measurement.
If the measurements of Distal Internal Carotid Diameter not Referenced or any other Reason not specified should append a reporting modifier 8P to CPT Category II code 3100F to report circumstances when the action described in the numerator is not performed and the reason is not otherwise specified.
3100F with 8P: Carotid imaging study report did not include direct or indirect reference to measurements of distal internal carotid diameter as the denominator for stenosis measurement, reason not otherwise specified.
Hope, this article helps you code CPT code for carotid Doppler studies. If you liked the article, do share it.

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Physician Quality Reporting System (PQRS) used for CPT code 93880 & 93882

Measure 195 Radiology: Stenosis Measurement in Carotid Imaging Reports

CPT Codes
Code Modifier POS Description
36222     Selective catheter placement, common carotid or innominate artery, unilateral, any approach, with angiography of the ipsilateral extracranial carotid circulation and all associated radiological superv
70498     Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing
70547     Magnetic resonance angiography, neck; without contrast material(s)
70548     Magnetic resonance angiography, neck; with contrast material(s)
70549     Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences
93880     Duplex scan of extracranial arteries; complete bilateral study
93882     Duplex scan of extracranial arteries; unilateral or limited study
3100F     Carotid imaging study report (includes direct or indirect reference to measurements of distal internal carotid diameter as the denominator for stenosis measurement) (STR, RAD)
3100F 8P   Carotid imaging study report (includes direct or indirect reference to measurements of distal internal carotid diameter as the denominator for stenosis measurement) (STR, RAD)
3100F     Carotid imaging study report (includes direct or indirect reference to measurements of distal internal carotid diameter as the denominator for stenosis measurement) (STR, RAD)
3100F 8P   Carotid imaging study report (includes direct or indirect reference to measurements of distal internal carotid diameter as the denominator for stenosis measurement) (STR, RAD)

 

Other related CPT codes for Carotid doppler

Abdomen exam complete with doppler – CPT code 76700 , 93975

Kidney or Renal exam with doppler – CPT code 76770, 93975

Renal transplant exam with doppler – CPT code 76776

Renal Transplant exam without doppler- CPT code 76775

Penile Doppler Exam – CPT code 93980

Penile Doppler Exam follow up or Limited – CPT code 93981

Transcranial Doppler  exam complete – CPT code 93986

Transcranila Doppler exam Limited – CPT code 93888

Venous Doppler exam, Extremity bilateral – CPT code 93970

Venous Doppler exam, Extremity unilateral- CPT code 93971

 

 

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