ABI 2020 Coding and Reimbursement Guide

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. 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

E09.59

Drug or chemical induced diabetes mellitus with other circulatory complications

E10.59

Type 1 diabetes mellitus with other circulatory complications

E11.59

Type 2 diabetes mellitus with other circulatory complications

E13.59

Other specified diabetes mellitus with other circulatory complications

Not all inclusive diagnosis code list. 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: I70.231 ¨C I70.249

ICD-10-CM DIAGNOSIS CODES

I70.219

Atherosclerosis of native arteries of extremities with intermittent claudication, unspecified extremity

I70.228

Atherosclerosis of native arteries of extremities with rest pain, other extremity

I70.229

Atherosclerosis of native arteries of extremities with rest pain, unspecified extremity

I70.25

Atherosclerosis of native arteries of other extremities with ulceration

I70.269

Atherosclerosis of native arteries of extremities with gangrene, unspecified extremity

I70.299

Other atherosclerosis of native arteries of extremities, unspecified extremity

Aneurysm

Peripheral Vascular Disease

ICD-10-CM DIAGNOSIS CODES

ICD-10-CM DIAGNOSIS CODES

I72.4

I73.9

Aneurysm of artery of lower extremity

Peripheral vascular disease, unspecified

The above codes are examples only. 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

$77.74

$121.34

$149.77

Alaska

$99.62

$155.95

$192.15

Arizona

$83.42

$130.05

$160.64

Arkansas

$75.19

$117.38

$144.91

California-Anaheim/Santa Ana (26)

$100.04

$155.50

$192.61

California-Los Angeles (18)

$100.04

$155.50

$192.61

California-Napa (51)

$104.45

$162.16

$201.13

California-Marin (52)

$109.25

$169.51

$210.35

California-Solano (53)

$104.45

$162.16

$201.13

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)

$91.56

$142.44

$176.34

California-Kern County (54)

$91.77

$142.81

$176.73

California-San Luis Obispo County (73)

$92.55

$143.95

$178.24

California-Riverside and San Bernardino County (62)

$91.92

$143.07

$176.97

California-Placer and Sacramento County (63)

$92.25

$143.51

$177.67

California-Monterey County (64)

$95.00

$147.76

$182.96

California-Santa Cruz County (66)

$98.54

$153.12

$189.74

California-Sonoma County (67)

$97.16

$151.03

$187.11

California-Oakland/Berkeley (07)

$111.39

$172.79

$214.49

California-San Benito County (65)

$107.90

$167.51

$207.75

California-San Francisco (05)

$111.39

$172.79

$214.49

California-San Mateo (06)

$111.39

$172.79

$214.49

California-San Diego (72)

$96.24

$149.61

$185.32

California-Santa Clara (09)

$114.65

$177.79

$220.76

California-Ventura (17)

$99.97

$155.32

$192.46

California-Santa Barbara County (74)

$96.99

$150.75

$186.77

California-Imperial County (71)

$91.59

$142.50

$176.40

Colorado

$88.89

$138.57

$171.32

ABI

Ankle Brachial Index

2020 Coding and

Reimbursement Guide

2020 Medicare Part B Fee Schedule

MEDICARE GLOBAL IN-OFFICE (NON-FACILITY) REIMBURSEMENT

CPT Code 93922

CPT Code 93923

CPT Code 93924

Connecticut

$95.62

$148.82

$184.01

Delaware

$88.30

$137.57

$169.97

Florida-Ft. Lauderdale (03)

$88.27

$137.76

$169.70

Florida-Miami (04)

$90.90

$142.03

$174.57

Florida-Rest of Florida (99) (formerly 01/02)

$83.07

$129.70

$159.84

Georgia-Atlanta (01)

$86.46

$134.73

$166.43

Georgia-Rest of Georgia (99)

$78.15

$122.05

$150.48

Hawaii/Guam

$97.12

$150.91

$186.99

Idaho

$77.46

$120.84

$149.30

Illinois-Suburban Chicago (15)

$91.80

$143.08

$176.56

Illinois-Chicago (16)

$90.96

$141.92

$174.87

Illinois-East St. Louis (12)

$83.01

$129.71

$159.64

Illinois-Rest of Illinois (99)

$80.50

$125.71

$154.95

Indiana

$78.93

$123.06

$152.12

Iowa

$78.70

$122.71

$151.69

Kansas

$79.09

$123.34

$152.41

Kentucky

$76.76

$119.89

$147.87

Louisiana-New Orleans (01)

$83.16

$129.83

$160.00

Louisiana-Rest of Louisiana (99)

$77.77

$121.55

$149.69

Maine-Southern Maine (03)

$86.28

$134.35

$166.17

Maine-Rest of Maine (99)

$79.27

$123.66

$152.72

Maryland-Baltimore/Surrounding Co. (01)

$94.52

$147.21

$181.86

Maryland-Rest of Maryland (99)

$89.48

$139.40

$172.22

Massachusetts-Metropolitan Boston (01)

$101.46

$157.72

$195.27

Massachusetts-Rest of Massachusetts (99)

$91.63

$142.66

$176.38

Michigan-Detroit (01)

$87.03

$135.82

$167.37

Michigan-Rest of Michigan

$80.14

$125.09

$154.31

Minnesota

$86.60

$134.75

$166.86

Mississippi

$74.96

$117.03

$144.48

LOCATION

ABI

Ankle Brachial Index

2020 Coding and

Reimbursement Guide

2020 Medicare Part B Fee Schedule

MEDICARE GLOBAL IN-OFFICE (NON-FACILITY) REIMBURSEMENT

CPT Code 93922

CPT Code 93923

CPT Code 93924

Missouri-Metro St. Louis (01)

$84.14

$131.18

$161.98

Missouri-Metro Kansas City (02) (formerly 02/03)

$83.47

$130.17

$160.70

Missouri-Rest of Missouri (99) (formerly 01/06)

$75.60

$118.13

$145.61

Montana

$87.05

$135.74

$167.50

Nebraska

$78.64

$122.57

$151.61

Nevada

$86.84

$135.37

$167.13

New Hampshire

$89.79

$139.82

$172.83

New Jersey-Northern New Jersey (01)

$101.42

$157.66

$195.19

New Jersey-Rest of New Jersey (99)

$96.86

$150.67

$186.44

New Mexico

$79.91

$124.81

$153.81

New York-Manhattan (01)

$102.91

$160.24

$197.85

New York-NYC Suburbs/Long Island (02)

$105.37

$164.16

$202.41

$94.13

$146.65

$181.06

New York-Queens (04)

$105.41

$164.23

$202.50

New York-Rest of New York (99)

$82.49

$128.57

$158.89

North Carolina

$80.93

$126.23

$155.89

North Dakota

$85.87

$133.67

$165.43

Ohio

$80.21

$125.22

$154.43

Oklahoma

$77.74

$121.39

$149.74

Oregon-Portland (01)

$90.76

$141.23

$174.78

Oregon-Rest of Oregon (99)

$82.85

$129.12

$159.59

Pennsylvania-Metro Philadelphia (01)

$93.25

$145.24

$179.41

Pennsylvania-Rest of Pennsylvania (99)

$81.76

$127.55

$157.42

Puerto Rico

$87.21

$135.87

$167.87

Rhode Island

$90.55

$141.03

$174.30

South Carolina

$78.99

$123.22

$152.19

South Dakota

$85.70

$133.38

$165.14

Tennessee

$78.06

$121.77

$150.44

Texas-Brazoria (09)

$87.17

$135.79

$167.89

LOCATION

New York-Poughkeepsie/N NYC Suburbs (03)

ABI

Ankle Brachial Index

2020 Coding and

Reimbursement Guide

2020 Medicare Part B Fee Schedule

MEDICARE GLOBAL IN-OFFICE (NON-FACILITY) REIMBURSEMENT

CPT Code 93922

CPT Code 93923

CPT Code 93924

Texas-Dallas (11)

$87.81

$136.73

$169.12

Texas-Galveston (15)

$87.86

$136.83

$169.21

Texas-Houston (18)

$88.25

$137.51

$169.92

Texas-Beaumont (20)

$81.15

$126.53

$156.32

Texas-Fort Worth (28)

$85.51

$133.21

$164.72

Texas-Austin (31)

$89.15

$138.72

$171.68

Texas-Rest of Texas (99)

$82.13

$128.03

$158.20

Utah

$80.73

$125.98

$155.43

Vermont

$86.62

$134.85

$166.85

Virgin Islands

$87.21

$135.87

$167.87

Virginia

$85.79

$133.68

$165.17

Washington-Seattle/King Co. (02)

$99.63

$154.87

$191.77

Washington-Rest of Washington (99)

$87.27

$135.92

$168.04

Washington D.C.- MD/VA Suburbs

$104.29

$162.15

$200.62

West Virginia

$76.08

$118.98

$146.46

Wisconsin

$81.75

$127.34

$157.57

Wyoming

$86.41

$134.62

$166.38

LOCATION

*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 888.925.8166 or reimbursement@

Sources:

? 2020 AMA CPT Professional Edition

? 2020 ICD-10-CM The Complete Official Codebook, AMA

? 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

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