In many cases, performance of an ankle pressure and/or calculation of an ABI is considered part of the physical exam and not separately reimbursable. In that scenario, it would be acceptable. 


If you wish to charge for it (CPT 93922), then a separate physician's order with additional documentation in the patient’s record/office notes as to the medical necessity would be required. Some sort of hard copy documentation, associated Doppler waveforms for example would also be required.  Finally, many medicare contractors have specific training requirements for this, so if intending to bill for it, please check with your MAC. 


That said, while it would seem clear that a competent MA or other ancillary personnel could certainly be trained to perform this exam successfully and accurately. However, this “simple” measurement can prove somewhat more challenging than would seem from the casual observer. Pressure measurement notwithstanding, adding the Doppler component is the real issue. I have always argued that obtaining a high-quality and accurate Doppler waveform at the ankle is in fact,  technically challenging if not downright difficult.  


My thoughts Alessandro.



From: UVM Flownet <[log in to unmask]> On Behalf Of Alessandro Nardone
Sent: Friday, November 6, 2020 10:08 AM
To: [log in to unmask]
Subject: Training ABI


Hi All


Does anyone have or know of any position papers on training MA’s or other non sonographer personnel on performing ABI studies? It would be Very helpful if you would let me know. I did read a position paper on training fellows and doctors early in education but not what I was looking for. 


Thank you

Alessandro (Sandy) Nardone RVT, RVS

Northwell Health Western Region







Alessandro (Sandy) Nardone RVT,RVS, RCS 

Practice Coordinator Technical Imaging/Technical Director

Northwell Physician Partners- Cardiology Western Region

Cell: 516-382-1476


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