Current Procedural Terminology (CPT) codes serve as a standardized language for describing medical, surgical, and diagnostic services. They ensure that services are accurately documented and billed, streamlining medical administration and reimbursement by assigning a unique five-digit number to every procedure. This article focuses on CPT code 93922, which is used specifically for non-invasive testing of the body’s vascular system. Understanding this code clarifies its role in diagnosing conditions affecting blood flow in the limbs.
The Medical Procedure it Represents
CPT code 93922 is associated with the service “Non-invasive physiologic studies of extremity arteries, single level.” This test assesses blood flow in the arteries of the arms or legs. “Physiologic studies” means the procedure measures the function of the blood vessels, assessing blood pressure and flow characteristics. This non-imaging approach differentiates it from tests like ultrasound or angiography, which capture visual details of the vessel structure.
The primary purpose of this examination is to detect and characterize Peripheral Artery Disease (PAD). PAD occurs when fatty deposits narrow the arteries, most commonly in the legs, reducing blood flow. The test is typically ordered for patients presenting with symptoms such as leg pain during walking (intermittent claudication) or non-healing ulcers.
The term “extremity arteries” refers to the blood vessels in the upper or lower limbs. The “single level” designation means measurements are taken at one specific location, such as the ankle or wrist. Although the code technically describes a bilateral study, it is commonly used with a modifier to represent a limited, unilateral (single limb) evaluation when only one limb is clinically relevant.
Detailed Components of the Examination
The patient experience for this study is straightforward and involves no needles or injections. The procedure uses inflatable blood pressure cuffs placed around the limb being tested, typically at the ankle and the arm. A Doppler device, which uses high-frequency sound waves, measures the blood flow and pressure distal to the cuffs.
The technician uses the Doppler probe over specific arteries, such as the posterior tibial or dorsalis pedis artery in the ankle. The cuff is inflated to temporarily stop blood flow, then slowly deflated while the Doppler detects the return of the arterial pulse, providing a systolic pressure reading. This process is repeated on the arm to obtain the brachial systolic pressure.
The most recognized output of this single-level study is the Ankle-Brachial Index (ABI). The ABI is calculated by dividing the systolic blood pressure in the ankle by the highest systolic blood pressure in either arm. A normal ABI value is between 1.0 and 1.4, while a value of 0.90 or less indicates PAD.
The test also often includes an analysis of the Doppler waveform, which represents blood flow velocity. A healthy artery produces a triphasic waveform with a rapid upstroke and flow reversal in early diastole. An abnormal, monophasic, or blunted waveform suggests a significant blockage upstream of the measurement site, providing a functional assessment of arterial health.
Coding Rules and Documentation Requirements
Proper use of CPT code 93922 requires adherence to specific documentation and billing guidelines. The physician must issue a formal order, and the patient’s medical record must establish medical necessity, often through PAD-related symptoms. The resulting report must detail all pressure readings and include a description of the Doppler waveform analysis.
For billing purposes, the service is divided into two distinct components: the technical component (TC) and the professional component (26). The technical component covers the cost of equipment, supplies, and the technician’s time to perform the study. The professional component accounts for the physician’s interpretation of the collected data and the generation of a final diagnostic report. These components can be billed separately or together, depending on the setting.
Since CPT code 93922 is defined as a bilateral study, reporting a single-limb evaluation requires a modifier. Providers must submit the code with modifier 52 (Reduced Services) to inform the payer that the procedure was deliberately limited to one limb. This single-level study must also be distinguished from a more comprehensive, multi-level examination, which is billed under CPT code 93923.