Non-invasive Arterial Duplex Ultrasound of the Upper and Lower Extremities
L40275
Non-invasive arterial duplex ultrasound (DUS) of the upper and lower extremities is covered when used to plan or monitor arterial revascularization/repair, to evaluate suspected or acute arterial occlusive disease (e.g., critical limb ischemia, claudication, rest pain, tissue loss, aneurysm, embolus), to assess grafts or prior interventions, or for mapping/confirmatory imaging when signs or symptoms of arterial disease are present. Coverage requires documentation of clinical signs/symptoms and medical necessity, performance by credentialed providers in accredited facilities, and adherence to specified frequency limits (e.g., post-operative exams at 1, 3, 6, and 12 months with a maximum of four studies in the initial post-operative year); routine screening of asymptomatic patients and certain isolated findings (e.g., isolated burning feet, nonspecific leg pain, edema without arterial signs, ABI alone, or use of non-documenting handheld Doppler) are not reasonable and necessary.