Cardiology Coding Alert

Question: Can 99201 or 99211 be billed with 93925 (ABI)?

Codify Member

Answer: There’s no Correct Coding Initiative (CCI) edit blocking you from reporting an E/M code with 93925 (Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study). Additionally, 93925 has an XXX global period indicator, meaning the global period concept doesn’t apply, and same-day E/M services aren’t automatically bundled into the procedure code.

But before reporting any of these codes, you should confirm that (1) documentation supports reporting a separate E/M, and (2) 93925 is the correct code for the service performed.

Separate E/M: Remember that to report an E/M code, documentation should support an E/M service independent of any procedure performed at the same encounter. In other words, if the procedure always requires certain pre- or post-service work, don’t try to report an E/M code for that required work. Payment is included in the procedure code.

ABI: You also should verify that 93925 is the appropriate code for the service provided because you mention only ABI. Review 93922-93923 (… bilateral noninvasive physiologic studies of upper or lower extremity arteries …) and the accompanying guidelines for services required in addition to ABI to use those codes. Specifically, the guidelines state, “The use of a simple hand-held or other Doppler device that does not produce hard copy output, or that produces a record that does not permit analysis of bidirectional vascular flow, is considered to be part of the physical examination of the vascular system and is not separately reported. The Ankle-Brachial Index (or ABI) is reportable with 93922 or 93923 as long as simultaneous Doppler recording and analysis of bidirectional blood flow, volume plethysmography, or transcutaneous oxygen tension measurements are also performed.”