When Axillary to fem bypass is performed we do prox native vessel  anastomoses graft itself along with distal anastomoses and distal native vessel. When it's Axillary to fem and fem to fem distal native vessel velocities are documented if a fem to pop is also ordered we do scan the graft anastomoses sights with imaging down to ankle,

Sent from my iPhone

> On Sep 10, 2014, at 7:58 AM, "Franklin W. West" <[log in to unmask]> wrote:
> 
> Steve,
> 
> I agree with that duplex codes typically would include 93931 and 93926 given
> the evaluation is limited to the extremities.  I further agree to 93922 is
> appropriate given the physiologic examination is limited to single level
> ABIs (along with the other caveats associated with this code).  I also agree
> that 93925 (in place of 93926)  could be appropriate if a complete bilateral
> duplex evaluation is medically necessary, ordered and performed.  However,
> many locations in which I've worked (and seen) included treadmill stress in
> the physiologic assessment given the patient is ambulatory, meaning 93924
> would be more appropriate to capture the increased expense.  
> 
> Also, while some lab protocols compare Doppler in the proximal graft with
> the distal graft and, assuming similar and normal, do not assess the graft
> in the thorax, abdomen or pelvis (these I would agree are consistent with
> duplex scenario you describe), others evaluate either the entire length of
> the graft or require checking at specified locations, in which case 93931/26
> fail to capture the work.  For those in this situation, depending on the
> definitions provided in their institutional protocols, etc., other codes
> might serve to capture this otherwise unclaimed, and thus unpaid, direct
> expense (notably including clinical staff time, equipment time and
> supplies).
> 
> Unfortunately, Tom does not describe what is included in evaluations at his
> institution and thus my hesitation to provide specific recommendations lest
> they not be appropriate to his situation.  I do agree that, at a typical
> minimum, 93931, 93926 and 93922 might be appropriate assuming evaluation
> limited to the extremities (basically anastomoses and immediate adjacent
> segments confined to the limbs).   
> 
> All the best,
> 
> /fww
> 
> -----Original Message-----
> From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Steven
> Knight
> Sent: Tuesday, September 9, 2014 3:02 PM
> To: [log in to unmask]
> Subject: Re: CPT codes
> 
> Tom,
> Typically we use the 93931 code for the inflow portion and a 93926 or 93925
> for the outflow depending on how much of the legs need to be evaluated.
> Ankle pressures and waveforms are usually ordered as well so we would
> include 93922.
> 
> 
> 
> Steve Knight BSc RVT RDCS
> Senior Vascular Technologist
> [log in to unmask]
> 
> Beth Israel Deaconess Medical Center
> CardioVascular Institute
> Division of Vascular and Endovascular Surgery
> 
> 110 Francis Street
> Boston, MA 02215
> 
> (617) 632-9962 Phone
> (617) 632-7977 Fax
> www.bidmc.org
> 
> 
> 
> -----Original Message-----
> From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Tom
> Sent: Thursday, September 04, 2014 10:34 AM
> To: [log in to unmask]
> Subject: CPT codes
> 
> Curious what CPT code everyone
> Is using for Axillary to fem bypass grafts. Also fem to fem bypass grafts.
> Need help please.
> 
> Sent from my iPhone
> 
> To unsubscribe or search other topics on UVM Flownet link to:
> http://list.uvm.edu/archives/uvmflownet.html
> 
> This message is intended for the use of the person(s) to whom it may be
> addressed. It may contain information that is privileged, confidential, or
> otherwise protected from disclosure under applicable law. If you are not the
> intended recipient, any dissemination, distribution, copying, or use of this
> information is prohibited. If you have received this message in error,
> please permanently delete it and immediately notify the sender. Thank you.
> 
> To unsubscribe or search other topics on UVM Flownet link to:
> http://list.uvm.edu/archives/uvmflownet.html
> 
> To unsubscribe or search other topics on UVM Flownet link to:
> http://list.uvm.edu/archives/uvmflownet.html
> 

To unsubscribe or search other topics on UVM Flownet link to:
http://list.uvm.edu/archives/uvmflownet.html