Billing and Coding: Non-Invasive Arterial Duplex Ultrasound of the Upper and Lower Extremities

Non-invasive arterial duplex ultrasound of the upper and lower extremities (CPT 93925, 93926, 93930, 93931) is covered when reasonable and necessary per LCD DL40276, with specific allowances for preoperative planning, post-surgical monitoring, and inpatient/emergency evaluations. Routine studies are limited to once per year except for the listed exceptions; post-operative monitoring is limited to six studies in the first year (specified timepoints) and then annually, and multiple billing restrictions prohibit same-day billing with venous duplex codes or simultaneous upper/lower extremity arterial studies.

"Arterial duplex ultrasound is covered when reasonable and necessary as defined by Local Coverage Determination DL40276 for evaluation of the upper or lower extremity arterial system."

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