# 93922 vs 93923 PVR'S



## RADCODER

Hello all.. I could really use your expertise on this one. I do have a specific question regarding CPT codes 93922 vs 93923.
I am having quiet the dilemma trying to dissect the meaning of the codes. I am still confused about one crucial piece of information = the levels! For example,

"Pressure waveform analysis was performed in both right and left ankles.
Right and left brachial pressures were also obtained.
The waveforms are symmetric and normal in appearance in both right and left ankles.
The right brachial pressure is 158mmHg abd the left brachial pressure is 166mmHg.
On the right, the DP pressure is 174mmHg and the PT pressure is 137mmHg. The right ABI is 1.05.
On the left, the DP pressure is 169mmHg and the PT pressure is 184mmHg. The left ABI is 1.11.

IMPRESSION: Normal right and left lower extremity ABI's. Findings are not suggestive of peripheral arterial disease."

How do I decipher the levels?* Do I count the brachial pressures as a level as well *or is it just used as a comparison to the lower extremities? In other words, would I only count ABI at DP and ABI at PT (2 levels 93922)?

IF ANYONE HAS ANY INPUT I would greatly appreciate the feedback!
Sorry for the extensive post, but I am having a difficult time understanding this specific part.


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## Lynda Wetter

I to have questioned this myself! And yes I believe you may be correct that example would be 93922. I understand that the levels are measured by how many locations the pressure cuff is moved on the extremity to get the pressure readings!

....hope this helps


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## RADCODER

I am getting so many mixed opinions. Some people say to code the Brachial pressure(upper extremity) as a level *in addition *to the other pressure readings (lower extremity) levels. But again some others are saying to count only the pressure measurements on the lower extremity as *THE* levels and only compare them to the Brachial pressure (upper extremity).


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## Lynda Wetter

http://codingnews.inhealthcare.com/coding-challenge/2011-guidelines-for-93922/

does this help at all???


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## chembree

This may also help...

Per CPT Assistant...
Code 93922 represents a noninvasive physiologic arterial study of either both upper extremities (UE) or both extremities (LE) performed at only one level of the involved extremities. An example of a single level study is an evaluation of non-imaging physiologic recordings of pressures Doppler analysis of bi-directional blood flow, plethymography, and or oxygen tension measurements at each ankle. Again , if this evaluation does not produce hard copy output or, for Doppler testing procedure a record that does not permit analysis of bi-directional blood flow direction, then the evaluation is considered to be part of the E/M service and is not separately reportable.


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