2011 Guidelines For 93922

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)...

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.

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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
5. Metatarsal
6. Toes

Lower Extremity Levels

Upper Extremity Levels

1. High thigh

1. Arm

2. Low thigh

2. Forearm

3. Calf

3. Wrist

4. Ankle

4. Digits

5. Metatarsal

6. Toes

CPC Exam Study Guide
CCA Exam Study Guide
CCS Exam Study Guide
CPB Exam Study Guide
CRC Exam Study Guide
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