ABI 2020 Coding and Reimbursement Guide - CooperSurgical

1 ABI. ankle brachial index 2020 Coding and Reimbursement Guide Reimbursement and Coding information provided herein is gathered from third-party sources and is subject to change. This information is presented for illustrative purposes only. This information does not constitute Reimbursement or legal advice, and is not intended as a guarantee of coverage or payment at any particular payment rate. CooperSurgical makes no representation or warranty regarding this information or its completeness, accuracy or timeliness. Laws, regulations and payer policies concerning Reimbursement are complex and change frequently. The decision about which code(s) to report must be made by the billing provider/ physician considering the clinical facts, circumstances, and applicable Coding rules. The code(s) selected should be supported by the contents of any clinical notes and/or chart documentation.

2 Please contact your third-party payer for more specific guidance. CPT Code: 93922 Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries. CPT Code: 93923 Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels. CPT Code: 93924 Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing. Possible ICD-10-CM Diagnosis Codes for Procedure Code 93922, 93923 and 93924. Not all inclusive diagnosis code list. Refer to ICD-10-CM manual for code specificity. Note: Arterial exams must be considered medically necessary in order to be eligible for Reimbursement . E08-E13 - Diabetes Mellitus For specificity, refer to additional codes within this category. ICD-10-CM DIAGNOSIS CODES. Drug or chemical induced diabetes mellitus with other circulatory complications Type 1 diabetes mellitus with other circulatory complications Type 2 diabetes mellitus with other circulatory complications Other specified diabetes mellitus with other circulatory complications Not all inclusive diagnosis code list.

3 Refer to manual for code specificity. I70-I79 - Diseases of arteries, arterioles and capillaries For extended ICD-10 diagnosis specific to extremity and anatomical location refer to: ICD-10-CM DIAGNOSIS CODES. Atherosclerosis of native arteries of extremities with intermittent claudication, unspecified extremity Atherosclerosis of native arteries of extremities with rest pain, other extremity Atherosclerosis of native arteries of extremities with rest pain, unspecified extremity Atherosclerosis of native arteries of other extremities with ulceration Atherosclerosis of native arteries of extremities with gangrene, unspecified extremity Other atherosclerosis of native arteries of extremities, unspecified extremity Aneurysm Peripheral Vascular Disease ICD-10-CM DIAGNOSIS CODES ICD-10-CM DIAGNOSIS CODES. Aneurysm of artery of lower extremity Peripheral vascular disease, unspecified The above codes are examples only.

4 Check the appropriate Medicare Administrative Contractor (MAC) local coverage policy for your jurisdiction for a complete list of ICD-10-CM codes. ABI. ankle brachial index 2020 Coding and Reimbursement Guide 2020 Medicare Part B Fee Schedule MEDICARE GLOBAL IN-OFFICE (NON-FACILITY) Reimbursement . LOCATION CPT Code 93922 CPT Code 93923 CPT Code 93924. Alabama $ $ $ Alaska $ $ $ Arizona $ $ $ Arkansas $ $ $ California-Anaheim/Santa Ana (26) $ $ $ California-Los Angeles (18) $ $ $ California-Napa (51) $ $ $ California-Marin (52) $ $ $ California-Solano (53) $ $ $ California-Butte County (55), Fresno County (56), Kings County (57), Madera County (58), Merced County (59), Stanislaus County (60), $ $ $ Shasta County (61), San Joaquin County (68), Tulare County (69), Sutter County (70), all other Counties (75). California-Kern County (54) $ $ $ California-San Luis Obispo County (73) $ $ $ California-Riverside and San Bernardino County (62) $ $ $ California-Placer and Sacramento County (63) $ $ $ California-Monterey County (64) $ $ $ California-Santa Cruz County (66) $ $ $ California-Sonoma County (67) $ $ $ California-Oakland/Berkeley (07) $ $ $ California-San Benito County (65) $ $ $ California-San Francisco (05) $ $ $ California-San Mateo (06) $ $ $ California-San Diego (72) $ $ $ California-Santa Clara (09) $ $ $ California-Ventura (17) $ $ $ California-Santa Barbara County (74) $ $ $ California-Imperial County (71) $ $ $ Colorado $ $ $ ABI.

5 ankle brachial index 2020 Coding and Reimbursement Guide 2020 Medicare Part B Fee Schedule MEDICARE GLOBAL IN-OFFICE (NON-FACILITY) Reimbursement . LOCATION CPT Code 93922 CPT Code 93923 CPT Code 93924. Connecticut $ $ $ Delaware $ $ $ Florida-Ft. Lauderdale (03) $ $ $ Florida-Miami (04) $ $ $ Florida-Rest of Florida (99) (formerly 01/02) $ $ $ Georgia-Atlanta (01) $ $ $ Georgia-Rest of Georgia (99) $ $ $ Hawaii/Guam $ $ $ Idaho $ $ $ Illinois-Suburban Chicago (15) $ $ $ Illinois-Chicago (16) $ $ $ Illinois-East St. Louis (12) $ $ $ Illinois-Rest of Illinois (99) $ $ $ Indiana $ $ $ Iowa $ $ $ Kansas $ $ $ Kentucky $ $ $ Louisiana-New Orleans (01) $ $ $ Louisiana-Rest of Louisiana (99) $ $ $ Maine-Southern Maine (03) $ $ $ Maine-Rest of Maine (99) $ $ $ Maryland-Baltimore/Surrounding Co. (01) $ $ $ Maryland-Rest of Maryland (99) $ $ $ Massachusetts-Metropolitan Boston (01) $ $ $ Massachusetts-Rest of Massachusetts (99) $ $ $ Michigan-Detroit (01) $ $ $ Michigan-Rest of Michigan $ $ $ Minnesota $ $ $ Mississippi $ $ $ ABI.

6 ankle brachial index 2020 Coding and Reimbursement Guide 2020 Medicare Part B Fee Schedule MEDICARE GLOBAL IN-OFFICE (NON-FACILITY) Reimbursement . LOCATION CPT Code 93922 CPT Code 93923 CPT Code 93924. Missouri-Metro St. Louis (01) $ $ $ Missouri-Metro Kansas City (02) (formerly 02/03) $ $ $ Missouri-Rest of Missouri (99) (formerly 01/06) $ $ $ Montana $ $ $ Nebraska $ $ $ Nevada $ $ $ New Hampshire $ $ $ New Jersey-Northern New Jersey (01) $ $ $ New Jersey-Rest of New Jersey (99) $ $ $ New Mexico $ $ $ New York-Manhattan (01) $ $ $ New York-NYC Suburbs/Long Island (02) $ $ $ New York-Poughkeepsie/N NYC Suburbs (03) $ $ $ New York-Queens (04) $ $ $ New York-Rest of New York (99) $ $ $ North Carolina $ $ $ North Dakota $ $ $ Ohio $ $ $ Oklahoma $ $ $ Oregon-Portland (01) $ $ $ Oregon-Rest of Oregon (99) $ $ $ Pennsylvania-Metro Philadelphia (01) $ $ $ Pennsylvania-Rest of Pennsylvania (99) $ $ $ Puerto Rico $ $ $ Rhode Island $ $ $ South Carolina $ $ $ South Dakota $ $ $ Tennessee $ $ $ Texas-Brazoria (09) $ $ $ ABI.

7 ankle brachial index 2020 Coding and Reimbursement Guide 2020 Medicare Part B Fee Schedule MEDICARE GLOBAL IN-OFFICE (NON-FACILITY) Reimbursement . LOCATION CPT Code 93922 CPT Code 93923 CPT Code 93924. Texas-Dallas (11) $ $ $ Texas-Galveston (15) $ $ $ Texas-Houston (18) $ $ $ Texas-Beaumont (20) $ $ $ Texas-Fort Worth (28) $ $ $ Texas-Austin (31) $ $ $ Texas-Rest of Texas (99) $ $ $ Utah $ $ $ Vermont $ $ $ Virgin Islands $ $ $ Virginia $ $ $ Washington-Seattle/King Co. (02) $ $ $ Washington-Rest of Washington (99) $ $ $ Washington MD/VA Suburbs $ $ $ West Virginia $ $ $ Wisconsin $ $ $ Wyoming $ $ $ * For a complete list of ICD-10-CM diagnosis codes, please consult the 2019 ICD-10-CM codebook. CooperSurgical is not suggesting that the above CPT codes will be covered if you use these ICD codes. For More Information Contact the Reimbursement Center at or Sources: 2020 AMA CPT Professional Edition 2020 ICD-10-CM The Complete Official Codebook, AMA.

8 2019 National Physician Fee Schedule Relative Value File CY2019 Final Rule 11/23/2018. Medicare - National Correct Coding Policy Manual, Physician Version 23 Effective January 1, 2019. Reference: 2020. Current Procedural Terminology (CPT ) copyright 2019 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association. Applicable FARS/DFARS Restrictions Apply to Government Use. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein. 2020 CooperSurgical , Inc. US-ABI-2000001 Rev. 5/20.