Basics of CPT code 93886
CPT Code 93886 is Transcranial Doppler study of Intracranial arteries; complete study. It requires bilateral insonation and waveforms from all major vessels with the cranium through the Temporal acoustic window. These vessels include the Middle Cerebral Artery (MCA), Anterior Cerebral Artery (ACA), and Posterior Cerebral Artery (PCA). The Posterior window will need to be insonated to detect Vertebral (VA) and Basilar arteries. The Orbital Window- Occipital artery & Carotid Waveform – Internal Carotid Artery (ICA).
Sample coded report for CPT code 93886
US TRANSCRANIAL DOPPLER
CLINICAL HISTORY: Subarachnoid hemorrhage.
COMPARISON: US Transcranial Doppler
TECHNIQUE: Transcranial Color Doppler ultrasound was performed of the intracranial circulation. Peak systolic velocities and arterial waveforms were reviewed. Temporal average peak velocities utilized for assessment of vascular spasm.
FINDINGS:
Temporal averaged peak velocities measure as follows:
Left MCA: 24-86 cm/sec
Left ACA: 80-84 cm/sec
Left PCA: 26-40 cm/sec
Right MCA: 29-57 cm/sec
Right ACA: Not visualized
Right PCA: 25-28 cm/sec
Basilar: 50-52 cm/sec
Right Vertebral: 26 cm/sec
Left Vertebral: 11-12 cm/sec
IMPRESSION:
1. Nonvisualization of the right anterior cerebral artery. No sonographic evidence of vasospasm within the remainder of the visualized intracranial vessels.
Abnormal Values for Arterial Vasospasm
MCA < 120 cm/sec (normal)
MCA 120-150 cm/sec (mild)
MCA 150-180 cm/sec (moderate)
MCA 180-200 cms/sec (severe)
MCA > 200 cm/sec (critical)
ACA > 130 cm/sec
PCA > 110 cm/sec
VA > 80 cm/sec
BA > 95 cm/sec
Lindegaard Ratio = Mean Velocity MCA/Mean Velocity ICA
> 6.0 critical
< 3.0 normal
CPT 93886 – Transcranial Doppler study of Intracranial arteries; complete study
