Cardiology Coding Alert

Question: I was always told to use procedure codes 93875 and 93880 to code carotid artery studies. It has come to my attention recently that I may have been coding these procedures incorrectly. The Health Care Financing Administration now says 93875 is included in procedure code 93880. Is there a better way to code the carotid arterial study without downcoding and/or upcoding.

Theresa Bell, Billing Manager
Cardiovascular Associates of Jacksonville, FL

Answer: Until 1998, the study could be coded using both 93875 (non-invasive physiologic studies of extracranial arteries, complete bilateral study [e.g., periorbital flow direction with arterial compression, ocular pneumoplethysmography, Doppler ultrasound spectral analysis]) and 93880 (duplex scan of extracranial arteries; complete bilateral study). But in 1999, the doppler portion and the color flow mapping were bundled into the duplex scan by a black box edit, says Terry Fletcher, BS, CPC, CCS-P, a cardiology coding consultant in Dana Point, Calif. But the good news is, Fletcher says, that Medicare now pays for a pre-op scan and a three- to six-month post-carotid doppler, meaning cardiologists can bill for two studies in the same year.