Carotid Ultrasound is rated as Appropriate for Carotid artery dissection. Other Ultrasound protocols including Transcranial Doppler and other imaging modalities such as MRI or CT may be indicated.ī. Cerebrovascular ultrasound is rated as Appropriate for evaluation of vertebrobasilar occlusive disease. LIMITED STUDY INDICATIONS (CPT code: 93882)Ī limited study is indicated under the following circumstances:ġ) Post intervention surveillance where the contralateral carotid is free of disease.Ģ) Post intervention where the contralateral carotid has less than 70% stenosis and the surveillance period on the contralateral carotid has been less than 9 month.ģ) Emergent or urgent requests in the immediate postoperative or postprocedural period.Ī. * Baseline (within 1 month) after carotid intervention A (8) * No prior carotid artery assessment A (7) Surveillance After Carotid Artery Intervention 25. * Evaluation for suspected carotid artery dissection (b) A (8) * Suspected symptomatic vertebrobasilar occlusive disease in A (7) the symptomatic patient (e.g., vertigo, ataxia, diplopia, dysphagia, dysarthria)Ħ. * Syncope of uncertain cause after initial cardiovascular evaluation (d) U (5)ĥ. * Evaluation for subclavian–vertebral steal phenomenon A (7)Ĥ. * Lightheadedness or impaired vision in the setting of upper extremity exertion * Hollenhorst plaque visualized on retinal examination A (8)ģ. * Evaluation of transient ischemic attack or stroke A (9)Ģ. * New or worsening hemispheric neurological symptoms (e.g., unilateral motor or sensory deficit, speech impairment, or amaurosis fugax) (a) A median score of 1-3 indicates that the test is not generally acceptable for the indication.Įvaluation for Cerebrovascular Disease – Potential Signs and/or Symptomsġ. A median score of 4-6 indicates that there is unclear evidence as to the appropriateness of the test. A median score of 7-9 indicates that this is an appropriate test for the specific indication. These scenarios are scored for appropriate use on a scale of 1-9. 2D (Grayscale) and Doppler velocities are included.Ī review of common clinical scenarios where cerebrovascular ultrasound is used follows. Complete Cerebrovascular Ultrasound studies are bilateral unless there is a specific clinical indication that warrants a limited study and investigate the common, external and internal carotid arteries as well as the vertebral arteries. There are established criteria that are important to consider in order to ensure reliable, interpretable and meaningful results. Obtaining a high quality study requires the interplay of a number of factors. While cerebrovascular ultrasound is a relatively safe and widely available modality it does have its particular shortcomings and specific indications. 93880 – Duplex scan of extracranial arteries complete bilateral study -average fee amount -$200 -$210ĩ3875 – Noninvasive physiologic studies of extracranial arteries, complete bilateral study (eg, periorbital flow direction with arterial compression, ocular pneumoplethysmography, Doppler ultrasound spectral analysis)ĩ3882 – Duplex scan of extracranial arteries unilateral or limited studyĩ3886 – Transcranial Doppler study of the intracranial arteries complete studyĩ3888 – Transcranial Doppler study of the intracranial arteries limited studyĩ3890 – Transcranial Doppler study of the intracranial arteries vasoreactivity studyĩ3892 – Transcranial Doppler study of the intracranial arteries emboli detection without intravenous microbubble injectionĩ3893 – Transcranial Doppler study of the intracranial arteries emboli detection with intravenous microbubble injectionĪ Duplex scan is an ultrasonic scanning procedure used to characterize the pattern and direction of blood flow in arteries or veins with the production of real-time images.
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