Question: I’m confused by the 2011 guidelines for 93922-93923. When should I report 93922-52?
Answer: You should report 93922-52 (Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries … 1-2 levels; Reduced services) when the patient has only one limb available for study and the physician records only one or two levels.
Example: A patient has had his right leg amputated. The physician performs the study on two levels on the patient’s left leg. You should report this unilateral, limited service using 93922-52.
The source of the confusion may be that CPT guidelines for 93922 and for 93923 (Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels …) instruct you to report limited code 93922 when the physician performs a unilateral exam for three or more levels, or using provocative functional maneuvers, on a patient with only one arm or leg available for study.
In other words: That means 93922 (without modifier 52) is appropriate for:
- A bilateral exam on one or two levels
- A unilateral exam on three or more levels (that is, lower and/or upper extremity amputee)
- A unilateral exam when performing provocative functional maneuvers.
Experts recommend the following list to help you count levels:
|Lower Extremity Levels||Upper Extremity Levels|
|1. High thigh||1. Arm|
|2. Low thigh||2. Forearm|
|3. Calf||3. Wrist|
|4. Ankle||4. Digits|
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