Peripheral Vascular Disease (PVD) Imaging Guidelines

This policy covers diagnostic vascular imaging and related noninvasive testing for peripheral vascular disease and associated conditions—including evaluation of suspected peripheral artery disease (PAD), claudication/arterial insufficiency (with ankle‑brachial index testing), deep venous thrombosis, carotid/cerebrovascular disease, pulmonary artery hypertension, abdominal aortic aneurysm, renal/visceral vascular disorders, hemodialysis access, and arteriovenous malformations. Major requirements/limitations: a current clinical evaluation within 60 days is required before advanced imaging, atypical presentations require physician review, ABI is a non‑imaging test (post‑exercise testing allowed if resting ABI is normal), follow‑up imaging is primarily symptom‑driven, and specific CPT coding/billing restrictions apply (certain vascular codes must not be ordered/billed together).

"Relevant history and physical examination including:"