Does 93895 require prior authorization?

No, 93895 does not require prior authorization (high confidence). Code is covered without prior authorization.

What is the Medicare reimbursement rate for 93895?

Medicare facility rate: N/A. Non-facility rate: N/A. Work RVU: 0.00.

HCPCS/CPT

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Work RVU

0.00

Facility

N/A

Non-Facility

N/A

A permanent record of the studies performed and the interpretation must be maintained in the medical record.
The report must describe the studies performed and document any contrast media and/or radiopharmaceuticals used.
Any known significant patient reaction or complication must be recorded in the medical record.
Comparison with prior relevant studies must be addressed and both normal and abnormal findings documented with measurements and descriptions of variations from normal.

Non-invasive cerebrovascular/vascular studies are covered when the study results will be used to directly inform or change the clinical management of the patient.
Re-evaluation of carotid artery stenosis is covered for patients with diameter reduction >50% who are symptomatic and these patients are normally followed on an annual basis.
Re-evaluation of carotid artery stenosis is covered for patients with diameter reduction >60% who are asymptomatic and these patients are normally followed on an annual basis.
Repeat duplex ultrasound scans are covered at any time for patients who become symptomatic of carotid disease, without regard to scheduled surveillance intervals.
Post–carotid endarterectomy (outside the global period) duplex ultrasonography is covered on the affected (ipsilateral) side at approximately 6 weeks, 6 months, and annually thereafter unless new symptoms develop.
One preoperative Doppler scan for bypass surgery is considered reasonable and necessary and is covered.

A57592 — Billing and Coding: Non-Invasive Cerebrovascular Studies

J05

L35753 — Non-Invasive Cerebrovascular Studies

J05

SUREST-POL-SUREST-cardiovascular-disease-risk-tests — Cardiovascular Disease Risk Tests

UHC-POL-cardiovascular-disease-risk-tests — Cardiovascular Disease Risk Tests

REGENCE-RAD37

Ask Verity about documentation requirements, denial risks, or coverage in your state.