Forum - Questions & Answers

May 6th, 2009 - mchung

Correct CPT code use

The New diagnostic test procedure that we are trying to code is a test that is a noninvasive bilateral physiologic study of upper extremity arteries and is a measurement with reactive hyperemia. This is a newer type device using a different type of technology but is administered similar to existing technology. The code that is most similar in description is CPT code 93923.

CPT 93923 (Long Description) Noninvasive physiologic studies of upper or lower extremity arteries, multiple levels with provocative functional maneuvers, complete bilateral study (e.g. segmental blood pressure measurements, segmental Doppler waveform analysis, volume plethysmography, segmental transcutaneous oxygen tension measurements, measurements with postural provocative tests, measurements with reactive hyperemia)

Although not 100% of components are provided as mentioned in this code it clearly is the code that is the closest in description. Can we bill with CPT 93923?

May 6th, 2009 -

Ask the manufacturer!

They should provide you with codes for billing; many of these new devices are "squeezed" into existing codes by the manufacturers to get good reimbursement and to sell machines.
Then the insurers look again and realize what is happening and take away the good reimbursement by getting a new code that pays less. That is what happened with the Neurometrix automated EMG machine for testing peripheral neuropathy and carpal tunnel- they sold lots of machines then the insurers said it wasn't a true EMG and stopped paying at all!
But of course I have never heard of the test to which you are referring so I may be totally off base....



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