Basics of CPT code 93985 & 93986

Their are two CPT codes for Non-Invasive Extremity Aterial-Venous Studies. These CPT codes are for the extremity duplex scan including evaluation of both arterial inflow and venous outflow. CPT code 93985 & 93986 have been added for duplex scan studies for arterial inflow and venous outflow studies for bilateral and unilateral study respectively.

A complete extremity duplex scan (93985, 93986) includes evaluation of both arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access.

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Description of CPT code 93985 & 93986

93985 Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study

93986 complete unilateral study

For example, a 65 year old male patient comes for evaluation for an autogenous arteriovenous fistula for hemodialysis. Complete bilateral duplex scans of arterial inflow and venous outflow are performed. In this exam, evaluation of the bilateral upper extremity arterial inflow and venous outflow structures for the potential creation of a new hemodialysis access is performed.

This includes assessment of the anatomy, internal vessel diameters, patency and flow dynamics of the bilateral subclavian, axillary, brachial, median cubital, basilic and cephalic veins, as well as the axillary, brachial, ulnar and/or radial arteries. Special attention must be paid to the superficial veins regarding their suitability for use as arterial venous fistula. Analyze images, velocities, and data. Summarize findings regarding all evaluated vessels and make final recommendation regarding best fistula options. This procedure can be reported with CPT code 93985.

If the same scenrio is done only for the unilateral or only one side (RT or LT) then the procedure code will be reported with CPT code 93986.

If only an arterial extremity duplex scan is performed, use CPT code 93925, 93926, 93930, 93931. If only a venous extremity duplex scan is performed,  use CPT code  93970, 93971.

If a physiologic arterial evaluation of extremities is performed, use ABI index CPT code 93922, 93923, 93924.

Do not report 93985, 93986  in conjunction with 93925, 93930, 93970 for the same extremity[ies]

Related CPT codes for 93985 & 93986

93925 Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study

93926 unilateral or limited study

93930 Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study

93931 unilateral or limited study

93970 Duplex scan of extremity veins including responses to compression and other maneuvers;

complete bilateral study

93971 unilateral or limited study

93922  Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus bidirectional, Doppler waveform recording and analysis at 1-2 levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus volume plethysmography at 1-2 levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries with, transcutaneous oxygen tension measurement at 1-2 levels)

93923  Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental blood pressure measurements with bidirectional Doppler waveform recording and analysis, at 3 or more levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental volume plethysmography at 3 or more levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental transcutaneous oxygen tension measurements at 3 or more levels), or single level study with provocative functional maneuvers (eg, measurements with postural provocative tests, or measurements with reactive hyperemia)

93924  Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at rest with ankle/brachial indices immediately after and at timed intervals following performance of a standardized protocol on a motorized treadmill plus recording of time of onset of claudication or other symptoms, maximal walking time, and time to recovery) complete bilateral study

NCCI edits for CPT code 93985 & 93986