Non-Invasive Vascular Studies

Non-invasive vascular studies (duplex, physiologic studies, plethysmography, TCD) are covered when medical necessity is documented and results are expected to affect clinical or surgical management, including specific indications for cerebrovascular, peripheral arterial, peripheral venous, visceral vascular, and dialysis access evaluations. Screening asymptomatic patients, certain investigational uses (e.g., many TCD indications), non-bidirectional Doppler records without hard copy, and specified non-validated testing methods are excluded; credentialing/accreditation and specific documentation (referral, chart copies, evidence of device output and technician/physician qualifications) are required for coverage.

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