CPT 93975 Complete Duplex Scan
CPT code 93975 describes duplex scan of arterial inflow and venous outflow of abdomen, retroperitoneum, scrotal contents and/or pelvic organs. This code applies to a complete evaluation, and may be used whether single or multiple organs are studied. It is a "complete" study, in that all major vessels supplying blood flow (inflow and outflow, with or without color flow mapping) to the organ are evaluated bilaterally.
In cases where it is medically necessary to perform a duplex scan in conjunction with obstetrical ultrasound, it is appropriate to report CPT 93975 separately.
In order to code an abdominal duplex study, true vascular analysis needs to be performed. Abdominal duplex should not be coded when color is just turned on to determine if a structure is vascular.
Example:
A pregnant patient presents with left lower quadrant pain. A complete OB ultrasound (76805) is performed and documented. In addition, complete duplex scan was done to establish the arterial inflow and venous drainage of the ovaries, to evaluate for torsion.
Proper coding for this scenario is:
76805 or 76805-26 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (greater than or equal to 14 weeks 0 days)
93975-59 or 93975-26,59 Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study
Documentation must include the indication(s), detail of inflow and outflow, as well as a summary of the findings. Simply stating that the study was normal is not sufficient documentation to support the service.
As always, it is suggested that you contact your local payers for their individual/preferred coding guidelines.