Non-Invasive Vascular Studies

Non-invasive vascular studies (duplex, physiologic studies, plethysmography, TCD, Doppler flow) are covered when documented clinical signs/symptoms and expected impact on patient management exist and the patient is a candidate for invasive or surgical intervention. Specific covered indications include cerebrovascular symptoms (eg, TIA, amaurosis fugax, carotid bruit), peripheral arterial ischemia, DVT evaluation when anticoagulation/invasive therapy is considered, preoperative vein mapping for grafting or hemodialysis access, and symptomatic hemodialysis access dysfunction with defined hemodynamic thresholds; credentialing, referrals, and documentation (hard copy or digital imaging and chart copies) are required. Screening asymptomatic patients, vague non-anatomic symptom descriptions, certain TCD applications (eg, migraine, CPB monitoring except during CEA), and devices that do not provide bidirectional flow analysis/hard copy are not covered.

"Non-invasive vascular studies are medically necessary when the ordering physician reasonably expects test outcomes will potentially impact clinical management and significant signs or symptoms of a..."