I suspect there may be a misunderstanding of CPT coding requirements and/or
With the standard caveats - the following represents my personal opinions (not
those of my employer, any contracting entities, etc.) and, with $5, may purchase
the beverage of your choice at your local Starbucks ...
The lower extremity arterial physiologic CPT codes are listed below.
93922 Non-invasive physiologic studies of upper or lower extremity arteries,
single level, bilateral (eg, ankle/brachial indices, Doppler waveform analysis,
volume plethysmography, transcutaneous oxygen tension measurement)
93923 Non-invasive physiologic studies of upper or lower extremity arteries,
multiple levels or with provocative functional maneuvers, complete bilateral study
(eg, segmental blood pressure measurements, segmental Doppler waveform analysis,
segmental volume plethysmography, segmental transcutaneous oxygen tension
measurements, measurements with postural provocative tests, measurements with
93924 Non-invasive physiologic studies of lower extremity arteries, at rest and
following treadmill stress testing, complete bilateral study
Clearly, the key element for 93922 is evaluation at a "single level." Similarly,
93924 is clearly defined as requiring "treadmill" stress testing. This leaves
93923 to cover a somewhat less well-defined broad range of procedures, with the
key provisions being either "multiple levels" or "provocative functional
maneuvers." As such, while I am somewhat unclear of what is included in a "full
PVR" (sounds like it might be at multiple levels?), toe raises clearly meet the
definition of "provocative functional maneuvers."
Everything contained in parenthesis in the CPT code descriptions simply represent
examples that would qualify and are not individually required.
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