CPT® Code 93897

Official Description

Emboli detection without intravenous microbubble injection performed with transcranial Doppler study of intracranial arteries, complete (List separately in addition to code for primary procedure)

Common Language Description

Emboli detection is a specialized diagnostic procedure that utilizes a complete transcranial Doppler study of the intracranial arteries to identify the presence of emboli within the cerebral circulation. Emboli are small particles, which can be gaseous or solid, that travel through the bloodstream and may obstruct blood flow, potentially leading to serious neurological events such as stroke. During this procedure, high-intensity signals are detected using Doppler ultrasound technology, which measures the movement of blood cells and any embolic material present. The intensity of these signals varies based on the type of embolus; gaseous emboli typically produce the highest intensity signals, while solid emboli, such as those formed from thrombotic, platelet, or atheromatous material, generate slightly lower intensity signals. The procedure involves applying a gel to the patient's skin, positioning a handheld Doppler probe over the relevant areas, and conducting continuous monitoring of blood flow. The data collected is recorded on a computer system that provides both auditory and visual feedback. A sophisticated computer algorithm analyzes the recordings to identify potential embolic signals, which are then reviewed by a physician. The physician differentiates genuine embolic signals from artifacts and compiles a comprehensive written report that details the findings of the study, contributing to the overall assessment of the patient's vascular health.

1. Indications

Emboli detection using a transcranial Doppler study is indicated for various clinical scenarios where the presence of emboli may impact patient management and outcomes. The following conditions may warrant this procedure:

Stroke Evaluation Patients presenting with symptoms of stroke or transient ischemic attacks (TIAs) may require emboli detection to identify potential sources of embolism.
Cardiovascular Risk Assessment Individuals with known cardiovascular diseases or risk factors may undergo this study to evaluate the risk of embolic events.
Monitoring of Patients with Atrial Fibrillation Patients with atrial fibrillation are at increased risk for embolic strokes, and this procedure can help assess the presence of emboli.
Post-Surgical Monitoring Patients who have undergone certain cardiovascular or neurosurgical procedures may be monitored for embolic events as part of their postoperative care.

2. Procedure

The procedure for emboli detection through transcranial Doppler study involves several key steps that ensure accurate identification of embolic signals:

Preparation of the Patient The patient is positioned comfortably, and the area of the scalp where the Doppler probe will be applied is prepared. A conductive gel is applied to enhance the transmission of ultrasound waves.
Placement of the Doppler Probe A handheld Doppler probe is carefully positioned over the patient's skull at specific locations to access the intracranial arteries. The operator ensures that the probe is stable to obtain clear signals.
Continuous Monitoring The transcranial Doppler monitoring is initiated, allowing for continuous assessment of blood flow within the intracranial arteries. The system records both sound and visual data, capturing any high-intensity signals indicative of emboli.
Data Analysis A computer algorithm analyzes the recorded data in real-time, identifying potential embolic signals. This analysis is crucial for differentiating between genuine embolic events and artifacts that may arise during the study.
Review of Findings After the monitoring session is complete, the physician reviews the recorded data, focusing on high-intensity signals that may suggest the presence of emboli. The physician assesses the quality of the signals and their clinical significance.
Reporting Finally, the physician compiles a detailed written report summarizing the findings of the study, including any identified embolic signals and their potential implications for the patient's health.

3. Post-Procedure

Post-procedure care following an emboli detection study typically involves minimal intervention, as the procedure is non-invasive and does not require recovery time. Patients may resume normal activities immediately after the study. The physician will discuss the findings with the patient, including any identified embolic signals and their potential clinical significance. Further management or follow-up may be recommended based on the results, which could include additional imaging studies, medical therapy, or lifestyle modifications to reduce the risk of future embolic events. It is essential for patients to understand the importance of follow-up appointments to monitor their vascular health and address any ongoing concerns.

Short Descr	EMBOLI DETCJ WO IV MBUBB NJX
Medium Descr	EMBOLI DETCJ W/O IV MBUBB NJX TCD ICR ART COMPL
Long Descr	Emboli detection without intravenous microbubble injection performed with transcranial Doppler study of intracranial arteries, complete (List separately in addition to code for primary procedure)
Status Code	Active Code
Global Days	ZZZ - Code Related to Another Service
PC/TC Indicator (26, TC)	1 - Diagnostic Tests for Radiology Services
Multiple Procedures (51)	0 - No payment adjustment rules for multiple procedures 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	Items and Services Packaged into APC Rates
Berenson-Eggers TOS (BETOS)	none
MUE	Not applicable/unspecified.