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Official Description

Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

A duplex scan of arterial inflow and venous outflow is a comprehensive vascular ultrasound study that evaluates the blood flow dynamics within the abdominal, pelvic, and scrotal regions, as well as the retroperitoneal organs. This procedure employs both B-mode imaging and Doppler ultrasound techniques to provide a detailed assessment of the vascular structures. During the examination, a clear gel is applied to the skin to facilitate the transmission of sound waves. A B-mode transducer is then placed on the skin, generating real-time images of the arteries and veins. The Doppler component of the transducer assesses the flow of blood by detecting the movement of blood cells within the vessels. The interaction of sound waves with these moving cells produces audible signals that vary in pitch, indicating changes in blood flow, such as reductions or complete obstructions. The resulting data is processed by a computer, which creates color-coded images that illustrate the speed and direction of blood flow, as well as any potential blockages. Additionally, spectral Doppler analysis is conducted to evaluate anatomical structures and hemodynamic function, providing insights into conditions like vessel narrowing and plaque buildup. The physician interprets the findings from the duplex scan and documents the results in a written report. For a complete study, the appropriate code to use is 93975, while a limited study is coded as 93976.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The duplex scan of arterial inflow and venous outflow is indicated for various clinical scenarios where assessment of blood flow in the abdominal, pelvic, scrotal, and retroperitoneal regions is necessary. The following conditions may warrant this procedure:

  • Evaluation of Vascular Obstruction This procedure is performed to identify any blockages or obstructions in the blood vessels that may affect circulation.
  • Assessment of Blood Flow It is used to evaluate the adequacy of blood flow to specific organs or tissues, particularly in cases of suspected ischemia.
  • Investigation of Abnormal Findings The duplex scan is indicated when there are abnormal findings in physical examinations or other imaging studies that suggest vascular issues.
  • Monitoring of Vascular Conditions This study is also utilized for monitoring known vascular conditions, such as aneurysms or venous insufficiency, to assess changes over time.

2. Procedure

The procedure for conducting a duplex scan of arterial inflow and venous outflow involves several key steps to ensure accurate imaging and assessment. The following outlines the procedural steps:

  • Preparation of the Patient The patient is positioned comfortably, and the area of interest is exposed. A clear gel is applied to the skin to enhance the transmission of sound waves during the ultrasound examination.
  • Application of the B-mode Transducer A B-mode transducer is placed on the skin over the region being studied. This transducer emits ultrasonic sound waves that penetrate the skin and reflect off the blood vessels, creating real-time images of the arteries and veins.
  • Utilization of Doppler Technology The Doppler probe, integrated within the B-mode transducer, is used to assess blood flow. It detects the movement of blood cells and produces sound waves that vary in pitch based on the speed and direction of blood flow.
  • Image and Data Acquisition As the transducer is moved over the area, the reflected sound waves are converted into images and audible signals. The computer processes this data to generate color-coded images that illustrate blood flow dynamics, including speed and direction.
  • Conducting Spectral Doppler Analysis Spectral Doppler analysis is performed to provide detailed information about the anatomy and hemodynamic function of the blood vessels. This analysis helps identify any narrowing or plaque formation within the vessels.
  • Review and Interpretation After the duplex scan is completed, the physician reviews the images and data collected. A written interpretation of the findings is then documented for further evaluation and management.

3. Post-Procedure

Post-procedure care for the duplex scan of arterial inflow and venous outflow typically involves minimal recovery time, as the procedure is non-invasive and does not require sedation. Patients may resume normal activities immediately following the examination. The physician will discuss the results of the duplex scan with the patient, including any findings that may require further investigation or intervention. It is important for patients to follow any specific instructions provided by their healthcare provider regarding follow-up appointments or additional testing if necessary.

Short Descr VASCULAR STUDY
Medium Descr DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COM
Long Descr Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete 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 196 - Diagnostic ultrasound of abdomen or retroperitoneum
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.
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
GC This service has been performed in part by a resident under the direction of a teaching physician
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.
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
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
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).
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
GA Waiver of liability statement issued as required by payer policy, individual case
CR Catastrophe/disaster related
XP Separate practitioner, a service that is distinct because it was performed by a different practitioner
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
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
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.
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
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
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
25 Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service: it may be necessary to indicate that on the day a procedure or service identified by a cpt code was performed, the patient's condition required a significant, separately identifiable e/m service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed. a significant, separately identifiable e/m service is defined or substantiated by documentation that satisfies the relevant criteria for the respective e/m service to be reported (see evaluation and management services guidelines for instructions on determining level of e/m service). the e/m service may be prompted by the symptom or condition for which the procedure and/or service was provided. as such, different diagnoses are not required for reporting of the e/m services on the same date. this circumstance may be reported by adding modifier 25 to the appropriate level of e/m service. note: this modifier is not used to report an e/m service that resulted in a decision to perform surgery. see modifier 57 for significant, separately identifiable non-e/m services, see modifier 59.
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.
AM Physician, team member service
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
GW Service not related to the hospice patient's terminal condition
GY Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
HB Adult program, non geriatric
LT Left side (used to identify procedures performed on the left side of the body)
PD Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days
PT Colorectal cancer screening test; converted to diagnostic test or other procedure
Q3 Live kidney donor surgery and related services
QJ Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b)
RT Right side (used to identify procedures performed on the right side of the body)
SA Nurse practitioner rendering service in collaboration with a physician
U6 Medicaid level of care 6, as defined by each state
Date
Action
Notes
2013-01-01 Changed Medium Descriptor changed.
1992-01-01 Added First appearance in code book in 1992.
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