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Official Description

Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 93931 refers to a duplex scan of the upper extremity arteries or arterial bypass grafts, specifically indicating a unilateral or limited study. This procedure is a type of vascular ultrasound that employs both B-mode imaging and Doppler ultrasound techniques to assess the condition of the arteries in the upper extremities. During the examination, a clear gel is applied to the skin over the area of interest to facilitate the transmission of sound waves. A B-mode transducer is then placed on the skin, which generates real-time images of the arteries or any bypass grafts present. The Doppler component of the transducer is crucial as it measures the flow of blood within the arteries, providing insights into the direction and velocity of blood flow. The B-mode imaging utilizes ultrasonic sound waves that penetrate the skin and reflect off the arterial walls, allowing for visualization of the arterial structure. Meanwhile, the Doppler probe emits sound waves that interact with moving blood cells, and the resulting echoes are processed to produce audible sounds. Changes in the pitch of these sounds can indicate variations in blood flow, such as reductions or complete obstructions. The data collected during the scan is processed by a computer, which generates color-coded images that illustrate the speed and direction of blood flow, as well as any potential blockages. Additionally, spectral Doppler analysis is performed to evaluate anatomical details and hemodynamic function, including the detection of arterial narrowing and plaque buildup. Following the procedure, the physician interprets the findings and documents them in a written report. For a comprehensive bilateral study, the appropriate code to use is 93930, while code 93931 is designated for unilateral or limited studies.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The duplex scan of upper extremity arteries or arterial bypass grafts, coded as CPT® 93931, is indicated for various clinical scenarios. These indications may include:

  • Assessment of Arterial Patency to evaluate the status of blood flow in the upper extremities, particularly in patients with symptoms of vascular insufficiency.
  • Investigation of Symptoms such as pain, numbness, or weakness in the arms that may suggest underlying arterial disease.
  • Monitoring of Bypass Grafts to ensure the functionality and patency of previously placed arterial bypass grafts in the upper extremities.
  • Detection of Vascular Abnormalities including stenosis, occlusions, or other pathological changes in the arterial structure.

2. Procedure

The procedure for performing a duplex scan of the upper extremity arteries or arterial bypass grafts involves several key steps:

  • Preparation of the Patient involves positioning the patient comfortably, typically in a supine position, to allow easy access to the upper extremities. The skin over the area to be examined is cleaned, and a clear gel is applied to enhance the transmission of sound waves.
  • Application of the B-mode Transducer is the next step, where the sonographer places the B-mode transducer on the skin over the region of interest. This transducer emits ultrasonic sound waves that penetrate the skin and reflect off the arterial walls, creating real-time images of the arteries or bypass grafts.
  • Utilization of the Doppler Probe occurs simultaneously, as the Doppler component of the transducer is used to assess blood flow. The probe emits sound waves that bounce off moving blood cells, and the resulting echoes are processed to provide audible signals that indicate the direction and velocity of blood flow.
  • Image and Data Acquisition involves the computer processing the reflected sound waves to generate images that are color-coded to represent blood flow speed and direction. This step may also include spectral Doppler analysis to evaluate hemodynamic function and detect any abnormalities such as narrowing or plaque formation.
  • Interpretation of Results is performed by the physician, who reviews the duplex scan images and Doppler data to provide a comprehensive assessment of the upper extremity arteries or bypass grafts. A written report detailing the findings is then generated for medical records.

3. Post-Procedure

After the duplex scan is completed, there are typically no specific post-procedure care requirements, as the procedure is non-invasive and does not involve any recovery time. Patients can resume their normal activities immediately following the examination. The physician will review the results and discuss any necessary follow-up actions or treatments based on the findings of the duplex scan. It is important for the physician to communicate any significant results to the patient and to document the findings in the patient's medical record for future reference.

Short Descr UPPER EXTREMITY STUDY
Medium Descr DUP-SCAN UXTR ART/ARTL BPGS UNI/LMTD STUDY
Long Descr Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited 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 Procedure or Service, Not Discounted when Multiple
Type of Service (TOS) 5 - Diagnostic Laboratory
Berenson-Eggers TOS (BETOS) I3F - Echography/ultrasonography - other
MUE 1
CCS Clinical Classification 197 - Other diagnostic ultrasound
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.
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).
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
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
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
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.
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
GC This service has been performed in part by a resident under the direction of a teaching physician
GZ Item or service expected to be denied as not reasonable and necessary
GA Waiver of liability statement issued as required by payer policy, individual case
X4 Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period
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).
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.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
77 Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
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.)
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
CR Catastrophe/disaster related
CS Cost-sharing waived for specified covid-19 testing-related services that result in and order for or administration of a covid-19 test and/or used for cost-sharing waived preventive services furnished via telehealth in rural health clinics and federally qualified health centers during the covid-19 public health emergency
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GW Service not related to the hospice patient's terminal condition
MG The order for this service does not have applicable appropriate use criteria in the qualified clinical decision support mechanism consulted by the ordering professional
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
Q5 Service furnished under a reciprocal billing arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
X1 Continuous/broad services: for reporting services by clinicians, who provide the principal care for a patient, with no planned endpoint of the relationship; services in this category represent comprehensive care, dealing with the entire scope of patient problems, either directly or in a care coordination role; reporting clinician service examples include, but are not limited to: primary care, and clinicians providing comprehensive care to patients in addition to specialty care
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
XP Separate practitioner, a service that is distinct because it was performed by a different practitioner
Date
Action
Notes
1992-01-01 Added First appearance in code book in 1992.
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