Radiology practices often utilize CPT codes related to Carotid Doppler testing due to its widespread demand. There are only two CPT code 93880 & 93882 specifically associated with Carotid Doppler tests and it should be easy for physicians to recognize them as potential reimbursement CPT codes for reimbursement purposes.
What is a Carotid Doppler?
Carotid Doppler is a non-invasive ultrasound test used to detect any potential disorders within carotid arteries located within the neck region, such as obstruction or stenosis.
Description CPT Codes 93880 and 93882 for Carotid Doppler and Usage
| CPT Code |
Description |
Use Case |
Fee 2024 |
| 93880 | Duplex scan of extracranial arteries; complete bilateral study. | This code should be applied when an exam on both carotid arteries is being performed. | $189.74 |
| 93882 | Duplex scan of extracranial arteries; unilateral or limited study. | This code should be applied when an examination involving only a single carotid artery or having limited scope has taken place. | $124.50 |
Billing Requirements
To accurately bill for these procedures, specific documentation is necessary:
| CPT Code | Description |
| 93882 | Limited Duplex Scan |
| – Must include Color and Spectral Doppler | |
| 93880 | Complete Duplex Scan |
| – Must include Arterial Inflow, Venous Outflow, and Color & Spectral Doppler |
The cost of such procedures depends upon whether professional as well as technical services are being rendered and where these procedures take place.
Costs for CPT Code 93880 (Complete Bilateral Study):
| CPT Code | Component | Cost | In Hospital Setting |
| 93880 | Professional (26) | $40.91 | $205.64 |
| Technical (TC) | $164 |
Costs for CPT Code 93882 (Unilateral or Limited Study):
| CPT Code | Component | Cost | In Hospital Setting |
| 93882 | Professional (26) | $25 | $131 |
| Technical (TC) | $105 |
Examples of Use CPT code 93880 and 93882:
- Example 1: Any patient exhibiting symptoms of stroke should undergo a comprehensive bilateral study (CPT 93880) in order to check for blockages in both carotid arteries.
- Example 2: A patient with localized neck pain on one side may have a unilateral study (CPT 93882) to investigate a potential issue in one carotid artery.
Extracranial Arterial Studies (93880 – 93882)
Extracranial arterial studies involve various testing methods, including duplex scans and Doppler ultrasound waveform with spectral analysis. Due to technological assessments or because they form part of physical examination procedures, some methods are non-covered/non-reimbursable, additional testing might not always be covered/reimbursed either.
Indications for Medically Necessary and Unnecessary Studies
| Covered Testing Methods | Real-time duplex scans, Doppler ultrasound waveform with spectral analysis |
| Non-Covered Testing Methods | Methods not found to be useful based on technological assessments or part of the physical examination |
| Medically Necessary Indications | Asymptomatic/symptomatic cervical bruits, amaurosis fugax, focal cerebral/ocular transient ischemic attacks, syncope, recent history of cerebrovascular event, pre-surgery evaluation, post-endarterectomy follow-up, pulsatile neck mass, blunt/penetrating neck trauma, ocular microembolism |
| Medically Unnecessary Limitations | Drop attack/syncope (rare indications), dizziness (without localizing signs/symptoms), headaches (including migraines) |
Common Diagnoses Related to CPT Codes 93880 & 93882 for Carotid Doppler
Carotid Doppler exams, commonly identified with CPT codes 93880 and 93882, are performed primarily to diagnose any obstruction to carotid arteries. Their primary aim is to detect and measure any degree of stenosis as measured against its percentage occlusion score for each carotid artery segment.
| Condition | ICD 10 |
Definition |
| Carotid Artery Stenosis | I65.2 | Narrowing of the carotid arteries, measured as a percentage to indicate the degree of occlusion. |
| Transient Ischemic Attack (TIA) | G45.9 | Temporary period of stroke-like symptoms due to a decrease in blood flow to part of the brain. |
| Cerebrovascular Accident (Stroke) | I63.6 | Interruption or reduction in blood supply to the brain, preventing brain tissue from getting oxygen. |
| Amaurosis Fugax | G45.3 | Temporary loss of vision in one eye due to lack of blood flow to the retina. |
| Asymptomatic Carotid Bruit | R09.89 | A whooshing sound heard over the carotid artery during auscultation, indicating possible stenosis. |
| Cervical Bruit | R09.89 | Abnormal sound suggesting stenosis or abnormalities in the carotid arteries. |
| Syncope | R55 | Temporary loss of consciousness related to blood flow issues in the carotid arteries. |
| Dizziness or Vertigo | R42 | Symptoms that can be related to carotid artery disease, especially with other risk factors. |
| Numbness or Weakness in Limbs | M62.81 | Indicative of reduced blood flow to the brain due to carotid artery stenosis. |
| Neck Trauma | S19.9XXA | Injury to the neck, which can affect the carotid arteries and is evaluated with a carotid Doppler. |
Understanding PQRS Related to CPT Codes 93880 & 93882 for Carotid Doppler
The PQRS (Physician Quality Reporting System) measures that require Carotid Doppler are coded with CPT code 3100F in Category II CPT for Carotid Doppler under Measure 195 of PQRS and must meet certain key points when coded either with or without an 8P modifier. Below we outline these considerations when coding this measure as PQRS measures or codes such as 3100F with 8P modifier.
| CPT Code |
Comments |
| CPT II 3100F | The carotid Doppler ultrasound study reports must include direct or indirect references to measurements involving distal internal carotid diameter and its use as the denominator in measuring stenosis severity. |
| CPT II 3100F with Modifier 8P | In case the distal internal carotid diameter measurements were not referenced or for some unspecified reason were not completed, an 8P modifier must be added to CPT Category II code 3100F in the numerator to indicate this action was not performed and its reason cannot be given. This modifier serves to signal to readers of your report. |
Key Points to Remember:
| CPT Code |
Comments |
| 3100F | Make certain the carotid Doppler ultrasound report includes reference to distal internal carotid diameter measurements for stenosis detection. |
| 3100F with 8P | Indicates that the carotid Doppler ultrasound report did not include all necessary references; unfortunately, its cause remains unspecified. |
Physician Quality Reporting System (PQRS) used for CPT code 93880 & 93882
Measure 195 Radiology: Stenosis Measurement in Carotid Imaging Reports
| Code | Modifier |
Description |
Fee 2024 |
| 36222 | Selective catheter placement, common carotid or innominate artery, unilateral, any approach, with angiography of the ipsilateral extracranial carotid circulation and all associated radiological superv | $1,215.33 | |
| 70498 | Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing | $282.28 | |
| 70547 | Magnetic resonance angiography, neck; without contrast material(s) | $221.69 | |
| 70548 | Magnetic resonance angiography, neck; with contrast material(s) | $252.65 | |
| 70549 | Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences | $354.84 | |
| 93880 | Duplex scan of extracranial arteries; complete bilateral study | $189.74 | |
| 93882 | Duplex scan of extracranial arteries; unilateral or limited study | $124.50 | |
| 3100F | Carotid imaging study report (includes direct or indirect reference to measurements of distal internal carotid diameter as the denominator for stenosis measurement) | $0.00 | |
| 3100F | 8P | Carotid imaging study report (includes direct or indirect reference to measurements of distal internal carotid diameter as the denominator for stenosis measurement) | $0.00 |
| 3100F | Carotid imaging study report (includes direct or indirect reference to measurements of distal internal carotid diameter as the denominator for stenosis measurement) | $0.00 | |
| 3100F | 8P | Carotid imaging study report (includes direct or indirect reference to measurements of distal internal carotid diameter as the denominator for stenosis measurement) | $0.00 |
Other related CPT codes for Carotid doppler
| Code | Description | Fee 2024 |
| 76700, 93975 | Abdomen exam complete with doppler | $116.17, $263.97 |
| 76770, 93975 | Kidney or Renal exam with doppler | $108.18, $263.97 |
| 76776 | Renal transplant exam with doppler | $147.13 |
| 76775 | Renal Transplant exam without doppler | $59.58 |
| 93980 | Penile Doppler Exam | $116.84 |
| 93981 | Penile Doppler Exam follow up or Limited | $70.57 |
| 93986 | Transcranial Doppler exam complete | $145.47 |
| 93888 | Transcranial Doppler exam Limited | $159.45 |
| 93970 | Venous Doppler exam, Extremity bilateral | $186.74 |
| 93971 | Venous Doppler exam, Extremity unilateral | $118.84 |
Frequently Asked Questions (FAQ):
What is CPT code 93880?
The CPT code 93880 is a non-invasive diagnostic process known as a duplex scanning of the extracranial arterial arteries that includes the examination of the vertebral and carotid arterial arteries with ultrasonic technology.
Is CPT code 93880 an ultrasound?
Yes, CPT code 93880 refers to intended for a ultrasound-based procedure. It is together dual Doppler ultrasound to evaluate the flow of blood and to detect obstructions or irregularities in the vertebral and carotid arteries.
Does Medicare cover CPT code 93880?
Yes, Medicare usually will cover CPT code 93880 if medically required. The amount of coverage is contingent on the particular clinical indications and on the presence of the appropriate diagnostic codes.
What does CPT code 93880 mean?
The CPT code 93880 refers to a duplex scan that combine traditional ultrasound with Doppler ultrasound. It can focus on providing clear images and flow information for the vertebral and carotid arteries, which aids in diagnosing the presence of vascular issues.
What is the CPT code 93882?
The CPT code 93882 refers to an examination or follow-up of extracranial arteries using duplex Doppler ultrasound technology for tracking purposes, in order to establish whether further specific examination or imaging might be more suitable than full scan. This may determine if more focused examination might be more useful instead.
What is the CPT code for Doppler ultrasound of the carotid artery?
The CPT code 93880 covers Doppler ultrasound of the carotid artery as part of an extracranial duplex scan, this includes both carotid and vertebral arteries.
What ICD-10 code will cover carotid ultrasound?
Carotid ultrasound procedures may fall under several ICD-10 codes depending on a patient’s diagnosis, among these codes are I65.21 (Occlusion and Stenosis of Right Carotid Artery), as well as I65.22 (Occlusion and Stenosis of Left Carotid Artery), among many more. Each code should reflect medical necessity of performing carotid ultrasound imaging procedure.
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