Billing and Coding: Non-Invasive Vascular Studies
A56758
Medicare covers non-invasive vascular studies (e.g., duplex, Doppler, plethysmography, transcranial Doppler) when ordered by the treating practitioner and medically necessary, with specific coding guidance for access mapping (HCPCS 93985/93986; CPT 93970/93971). Monitoring studies of vascular access for ESRD patients are excluded from Part B separate payment and technical/professional components may be included in ESRD composite or MCP payments; documentation of medical necessity, ordering practitioner, valid ICD-10 diagnosis, and provider credentials is required. Surveillance frequencies are specified for carotid stenosis tiers, post-endarterectomy, and bypass grafts, while angioplasty follow-up intervals depend on vascular distribution and require justification.
"Non-invasive vascular studies (duplex scan, physiologic studies, plethysmography, transcranial Doppler) are covered when ordered by the treating or consulting practitioner and medically necessary t..."