Non-Invasive Cerebrovascular Arterial Studies

Non-invasive cerebrovascular arterial studies (duplex ultrasound, Doppler with spectral analysis, TCD, periorbital testing) are covered when used to evaluate clinical signs or symptoms (e.g., cervical bruit, hemispheric neurologic symptoms, carotid disease follow-up, suspected subclavian steal, retinal emboli, carotid dissection, or intraoperative/perioperative monitoring). Screening studies without signs or symptoms, studies that do not affect clinical decision making, certain TCD uses (e.g., tumor evaluation, epilepsy, migraine, autoregulation testing), and specified non-reimbursable methods are not covered. Documentation requirements include permanent hard-copy records, H&P/neurologic exam, provider certification/licensure and facility accreditation; specific frequency limits are defined in the policy's Utilization Guidelines.

"Duplex ultrasound, Doppler with spectral analysis, ocular pneumoplethysmography or periorbital Doppler may be performed to evaluate a patient with a cervical bruit."