Cardiology Coding Alert

Question: When can I report ABIs separately and when should I include them in the office visit services?California SubscriberAnswer: You typically should include an ankle/brachial index (ABI) test in office-visit services when the provider performs the ABI without other vascular studies. In addition, CPT's Noninvasive Vascular Diagnostic Studies guidelines say, "The use of a simple hand-held 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."Payer policy: Payers may not consider an ABI alone sufficient for 93922 (Noninvasive physiologic studies of upper or lower extremity arteries, single level, bilateral [eg, ankle/brachial indices, Doppler waveform analysis, volume plethysmography, transcutaneous oxygen tension measurement]). For example,  Palmetto GBA, California's Part B contractor, says, "CPT 93922 must include the ABIs and at least one [...]