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A transcranial Doppler study, specifically identified by CPT® Code 93890, is a non-invasive diagnostic procedure utilized to assess the vasoreactivity of the intracranial arteries. This study is particularly significant for patients with established cerebrovascular diseases affecting the carotid and/or vertebrobasilar arteries. The primary objective of the transcranial Doppler study is to evaluate the cerebrovascular reserve capacity, which is the ability of the brain's blood vessels to increase blood flow in response to various physiological challenges. Such evaluations are crucial, especially in preoperative settings where understanding blood flow dynamics is essential for surgical planning. The vasoreactivity study measures the variations in intracranial blood flow velocity that occur due to changes in carbon dioxide levels, which can be induced by inhaling a gas mixture with elevated carbon dioxide content, breath-holding, or hyperventilation. Additionally, the study may involve the administration of pharmacological agents, such as acetazolamide, to further assess the brain's blood flow response. During the procedure, a gel is applied to the patient's skin, and a hand-held Doppler probe is strategically placed over the middle cerebral arteries (MCAs) on both sides of the head. Continuous monitoring of blood flow velocity is conducted during a resting phase and subsequent to the physiological challenges, allowing for a comprehensive analysis of the cerebrovascular response. The results are processed through a computer program that calculates the changes in blood flow from baseline levels, and the physician subsequently reviews these findings to generate a detailed report. This report includes critical insights into the adequacy of collateral blood flow channels, which are vital for maintaining cerebral perfusion in the event of a stroke or during procedures that may temporarily disrupt blood flow to the brain.
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The transcranial Doppler study (CPT® Code 93890) is indicated for the following conditions:
The transcranial Doppler study involves several key procedural steps to ensure accurate assessment of intracranial blood flow.
After the transcranial Doppler study is completed, the patient may resume normal activities immediately, as the procedure is non-invasive and does not typically require recovery time. The physician will review the findings and provide a detailed report, which may include recommendations for further evaluation or management based on the results of the study. It is important for the physician to discuss the implications of the findings with the patient, particularly regarding the adequacy of collateral blood flow channels and any necessary follow-up actions.
| Short Descr | TCD VASOREACTIVITY STUDY | Medium Descr | TRANSCRANIAL DOPPLER INTRACRAN ART VASOREAC STDY | Long Descr | Transcranial Doppler study of the intracranial arteries; vasoreactivity study | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 1 - Diagnostic Tests for Radiology Services | Multiple Procedures (51) | 6 - Special payment adjustment rules on the technical component (TC) of multiple diagnostic cardiovascular services apply... | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | STV-Packaged Codes | Type of Service (TOS) | 6 - Therapeutic Radiology | Berenson-Eggers TOS (BETOS) | T2D - Other tests - other | MUE | Not applicable/unspecified. | CCS Clinical Classification | 192 - Diagnostic ultrasound of head and neck |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | TC | Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | GW | Service not related to the hospice patient's terminal condition | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 95 | Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system. | GA | Waiver of liability statement issued as required by payer policy, individual case | GC | This service has been performed in part by a resident under the direction of a teaching physician | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GZ | Item or service expected to be denied as not reasonable and necessary | N2 | Group 2 oxygen coverage criteria met | TD | Rn |
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Action
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Notes
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| 2024-12-31 | Deleted | Code Deleted. See 93896 |
| 2011-01-01 | Changed | Short description changed. |
| 2005-01-01 | Added | First appearance in code book in 2005. |
| 1991-12-31 | Deleted | Code deleted. |
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