Code 93922

Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus bidirectional, Doppler waveform recording and analysis at 1-2 levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus volume plethysmography at 1-2 levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries with, transcutaneous oxygen tension measurement at 1-2 levels)

(When only 1 arm or leg is available for study, report 93922 with modifier 52 for a unilateral study when recording 1-2 levels. Report 93922 when recording 3 or more levels or performing provocative functional maneuvers)

(Report 93922 only once in the upper extremity(s) and/or once in the lower extremity(s). When both the upper and lower extremities are evaluated in the same setting, 93922 may be reported twice by adding modifier 59 to the second procedure)

(For transcutaneous visible light hyperspectral imaging measurement of oxyhemoglobin, deoxyhemoglobin, and tissue oxygenation, use 0631T)

CPT information obtained from
Jagmin, C, Synovec, M, et al; CPT 2024 Current Procedural Terminology. Am Med Assoc 2024

Code 93923

Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental blood pressure measurements with bidirectional Doppler waveform recording and analysis, at 3 or more levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental volume plethysmography at 3 or more levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental transcutaneous oxygen tension measurements at 3 or more levels), or single level study with provocative functional maneuvers (eg, measurements with postural provocative tests, or measurements with reactive hyperemia)

(When only 1 arm or leg is available for study, report 93922 for a unilateral study when recording 3 or more levels or when performing provocative functional maneuvers)

(Report 93923 only once in the upper extremity(s) and/or once in the lower extremity(s). When both the upper and lower extremities are evaluated in the same setting, 93923 may be reported twice by adding modifier 59 to the second procedure)

(For transcutaneous visible light hyperspectral imaging measurement of oxyhemoglobin, deoxyhemoglobin, and tissue oxygenation, use 0631T)

CPT information obtained from
Jagmin, C, Synovec, M, et al; CPT 2024 Current Procedural Terminology. Am Med Assoc 2024

Indications for Use

The Smartdop^® XT6 is intended for use in the noninvasive evaluation of peripheral vascular pathology in patients. It detects systolic pressures for Ankle Brachial Index (ABI), Toe Brachial Index (TBI), and arterial and venous blood flow in extremities. Measurements are provided utilizing cuffs, photoplethysmography (PPG) and/or Doppler probe. The foot temperature probe (optional) provides skin temperature readings on the foot. Collected data is captured and stored with the Smart-XT-Link6 software that includes capabilities to print waveforms and export into the facility's electronic health records

Contraindications

The Smartdop^® XT6 is not intended to be used in fetal applications or used inside the sterile field.

CAUTION: Federal law (USA) restricts this device to sale by or on the order of a licensed healthcare practitioner. Rx only.

CAUTION: Perform ultrasound testing/procedures prudently using the principle of ALARA (As Low As Reasonably Achievable).

CAUTION: The Smartdop^® XT6 has not been evaluated for safety and compatibility in the MR environment. The Smartdop^® XT6 has not been tested for heating or migration in the MR environment.

For a complete listing of indications, contraindications, cautions and warnings, please refer to the operation manual provided with this product.