CPT Code 93922 identifies a non-invasive physiologic study performed on the arteries of an extremity. This procedure assesses the blood flow and pressure in the arms or legs without requiring incisions or injections. The study is a diagnostic tool used to check for blockages or narrowing in the arteries, which can restrict the movement of oxygenated blood to the limbs.
Defining CPT Code 93922
CPT Code 93922 is formally described as a “limited bilateral noninvasive physiologic study of upper or lower extremity arteries.” The term “physiologic” means the test focuses on the function of the blood vessels, measuring blood pressure and flow characteristics rather than imaging the vessel structure itself. This limited study typically involves a single level of assessment on both sides of the body, such as at the ankle in the lower extremities.
The “limited” designation distinguishes this procedure from a more extensive examination, such as the complete bilateral study covered by CPT Code 93923. The complete study requires measurements at three or more separate levels along the extremity, providing a more detailed map of arterial disease. Code 93922 is generally used when the clinical suspicion for widespread disease is lower or when a quick, initial screening is needed. This code covers the bilateral assessment of one set of limbs (arms or legs), but not both simultaneously.
How the Non-Invasive Study is Performed
The procedure is entirely non-invasive and generally painless for the patient. The patient typically lies on an examination table while a technician prepares the limbs for measurement. The study uses a combination of blood pressure cuffs and Doppler technology to assess the state of the arteries.
Blood pressure cuffs are placed on the limb being evaluated; for a lower extremity study, a cuff is also placed on the arm. The cuffs are inflated sequentially to temporarily restrict blood flow, similar to a standard blood pressure measurement. A small, handheld Doppler ultrasound device is then used to listen to the blood flow in the arteries just beyond the cuff.
The Doppler device emits high-frequency sound waves that reflect off moving red blood cells, allowing the technician to record the blood flow sounds and patterns, known as Doppler waveforms. These waveforms provide information about the speed and direction of the blood flow, which is then analyzed for signs of restriction. For a lower extremity study, the main output is the Ankle-Brachial Index (ABI), calculated by comparing the highest blood pressure recorded at the ankle to the highest pressure recorded in the arms.
Conditions Diagnosed by the Limited Study
The primary purpose of the limited extremity study is to screen for and diagnose Peripheral Arterial Disease (PAD). PAD is a common circulatory problem where narrowed arteries reduce blood flow to the limbs, most often the legs. This limited test acts as an initial diagnostic tool, especially for patients exhibiting common symptoms or having risk factors for vascular disease.
Symptoms that prompt this test often include claudication, which is muscle pain or cramping that occurs during exercise and is relieved by rest, or the presence of non-healing wounds on the feet or legs. An ABI value of 0.90 or less is a strong indicator that PAD is present, showing a significant drop in blood pressure from the arm to the ankle. The limited study helps assess the severity of arterial narrowing, with lower ABI values suggesting more severe disease.
The results of this study are crucial for determining the next steps in a patient’s care. If the limited study indicates significant arterial compromise, it justifies more comprehensive testing or consultation with a vascular specialist. Common risk factors such as diabetes, high blood pressure, and smoking make this screening test medically necessary to catch early signs of impaired circulation.