Non-invasive Arterial Duplex Ultrasound of the Upper and Lower Extremities

Non-invasive arterial duplex ultrasound of upper and lower extremities is covered when there is clinical suspicion of arterial disease requiring diagnostic localization, when pre- or post‑procedural planning or surveillance is indicated, or when signs/symptoms suggest ischemia, graft failure, or vascular injury. Routine screening of asymptomatic patients, testing for isolated neurologic symptoms (e.g., burning feet), ABI alone, use of non-documenting handheld Dopplers, and excessive repeat or same-day duplicate studies are not reasonable and necessary; provider and facility credentialing and documentation of medical necessity are required.

"Non-invasive arterial duplex ultrasound (DUS) is covered when arterial endovascular or other invasive arterial revascularization or repair is planned."

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