Peripheral Vascular Disease (PVD) Imaging Guidelines

This policy covers diagnostic imaging and noninvasive vascular testing for peripheral vascular disease, including arterial and venous duplex ultrasound, CTA/CTV, nuclear medicine perfusion studies, and ABI/toe‑brachial testing for conditions such as lower and upper extremity PVD, cerebrovascular/carotid disease, pulmonary hypertension, aortic/renal/visceral vascular disorders, AVMs, and hemodialysis access evaluation. Imaging requires a documented clinical evaluation within 60 days and symptomatic justification; atypical presentations need physician review, routine asymptomatic surveillance is limited unless guideline‑supported, and specific CPT coding/reporting limitations (including mutually exclusive duplex codes and ABI documentation requirements) apply.

"Simultaneous venous and arterial systems evaluation are unusual but are occasionally needed"

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