Radiology Coding Alert

Question: Can carotid Doppler (93880) be performed on the same day as venous Doppler (93965, 93970, 93971)? We're having trouble getting insurance to cover both on the same day.


Michigan Subscriber


Answer: National Correct Coding Initiative edits don't prevent you from reporting these codes together, but you payer may be questioning the medical necessity of performing both services on the same day. Doctors don't usually order both of these exams for the same patient on the same date of service.

Wisconsin Physician Services Local Coverage Determination shows the different indications for the different studies(www.wpsic.com/medicare/policies/wisconsin/cv033.pdf).

Code 93880: Indications for noninvasive physiologic cerebrovascular studies (including 93880, Duplex scan of extracranial arteries ...) include neck trauma, stroke and pulsatile tinnitus.

The studies may also be appropriate before a patient with systemic atherosclerosis has coronary artery bypass grafting or after a patient has carotid surgery.

Codes 93965, 93970, 93971: Indications for peripheral venous exams (including 93965, Non-invasive physiologic studies of extremity veins ...; and 93970-93971, Duplex scan of extremity veins ...) "are separated into three major categories: deep vein thrombosis, chronic venous insufficiency, and vein selection for arterial surgery. Studies, which are medically necessary to determine subsequent treatment, are covered."

Best Bet: Check with the referring physician to identify the reasons why the patient needs both exams.