Non-invasive Extracranial Arterial Studies

Non-invasive extracranial arterial studies (duplex/Doppler/B-mode) are covered when results could affect clinical management—examples include evaluation of symptomatic carotid bruits, recent stroke (<6 months), focal cerebral/ocular TIA, suspected carotid injury/dissection/aneurysm, subclavian steal, and monitoring of carotid stenosis. Monitoring intervals vary by stenosis severity (<30% not needed; 30–50% annually; >50% every 6 months) and post-endarterectomy surveillance is covered at 6 weeks, 6 months, 1 year, then annually. Coverage requires appropriate documentation, physician/technologist credentials or laboratory accreditation, adequate hard-copy/reporting, and avoidance of nonreimbursable methods or redundant testing.

"Initial non-invasive extracranial arterial study is covered for an asymptomatic carotid bruit identified on physical examination."

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