Radiology Coding Alert

READER QUESTIONS:

Use 52 for Unilateral 93922 and 93923

Question: Can I report 93926 for a unilateral noninvasive physiological study?


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Answer: Steer clear of this common mistake, and look to 93922 (Noninvasive physiologic studies of upper or lower extremity arteries, single level, bilateral [e.g., ankle/brachial indices, Doppler waveform analysis, volume plethysmography, transcutaneous oxygen tension measurement]) or 93923 (Noninvasive physiologic studies of upper or lower extremity arteries, multiple levels or with provocative functional maneuvers, complete bilateral study [e.g., segmental blood pressure measurements, segmental Doppler waveform analysis, segmental volume plethysmography, segmental transcutaneous oxygen tension measurements, measurements with postural provocative tests, measurements with reactive hyperemia]).

Important: Codes 93922 and 93923 describe bilateral services, so if for some reason the provider performs and documents a unilateral study, you should append modifier 52 (Reduced services) to the code to indicate that the provider did not perform the full service the code describes.

Common pitfall: Reporting 93926 (Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study) for a unilateral noninvasive study is tempting because you'll see the term "unilateral" when you quickly scan the codes. But you should report 93926 only if your physician performs the duplex scan. Code 93926 does not apply to the noninvasive physiologic studies that 93922 and 93923 describe.