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

Arterial duplex ultrasound of the upper and lower extremities (CPT 93925, 93926, 93930, 93931) is covered when reasonable and necessary per the LCD; generally limited to one study per extremity per year except for preoperative planning, post-surgical monitoring, or inpatient/emergency care. Billing restrictions prohibit same-day billing of arterial duplex with venous duplex or upper and lower arterial studies together, limit preoperative bypass scans to one (billed by the surgical provider), and cap post-operative monitoring at six studies in the first year with annual surveillance thereafter; complete, signed documentation and the surgical date (in claim box 19) are required for post-operative claims.

"Non-invasive arterial duplex ultrasound of the upper or lower extremities is covered when reasonable and necessary per the applicable LCD (DL40289) clinical criteria."