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Connie,

My father is Mr. West, I'm Frank  ;-)

93925 and 93926 are specific to arteries or bypass grafts in the
extremities.  93978 and 93979 are specific to aortoiliac, ileocaval or
bypass grafts in the region of the abdomen/retroperitoneum/pelvis.  In each
case, the difference between the respective codes is complete (25 & 78)
versus limited (26 & 79) procedures.  Consequently, these CPT codes are
specific to location.

A couple of examples:  duplex evaluation of a unilateral femoropopliteal
bypass graft might well be represented by 93926 whereas duplex evaluation of
an aortofemoral bypass graft might well be described with CPT codes 93979
and 93926.  In both cases, if physiologic testing is ordered and medically
necessary, then performing and billing one of the 93922/23/24 series of
codes would also be appropriate.

Admittedly, the difference is somewhat arbitrary but that is not uncommon in
CPT coding.  For example, diagnostic ultrasound (76xxx codes) separates the
abdomen from the pelvis with an imaginary line.


*************************************************
Franklin W. West
PVI
18702 North Creek Parkway, Suite 212
Bothell, Washington   98011
425.398.7774 (voice)
425.486.8976 (fax)
[log in to unmask]
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-----Original Message-----
From: [log in to unmask] [mailto:[log in to unmask]]On
Behalf Of Connie Mccoy
Sent: Thursday, February 08, 2001 3:08 PM
To: [log in to unmask]
Subject: Re: CPT coding for vascular testing


Mr. West,

Could you also clarify the difference in charge for a graft surveillance
using 93978 and 93979 vs. 93925 and 93926?  Is it the location and/or type
of bypass?

Connie McCoy
Mercy Franciscan