CPT Code 93925: Bilateral duplex scan of lower extremity arteries

Key takeaways

CPT Code 93925 describes a complete bilateral duplex scan of lower extremity arteries or arterial bypass grafts. The study combines B-mode imaging, Doppler spectral analysis, and color flow mapping.

93925 requires documentation confirming both limbs were evaluated. Billing this code when only one limb was scanned is the most common audit trigger and denial cause.

Accepted ICD-10 pairings include I73.9, I70.209, I70.219, and related peripheral arterial disease codes. Payer acceptance varies by MAC jurisdiction, so verify the applicable LCD before billing.

Practice management software like Pabau supports clean claim submission for vascular duplex studies. It attaches supporting ICD-10 codes, applies modifiers, and flags missing documentation before a claim goes out.

CPT Code 93925 is the procedure code for a complete bilateral duplex scan of the lower extremity arteries or arterial bypass grafts. It covers both legs in a single session, using B-mode imaging, Doppler spectral waveform analysis, and color flow mapping. Incomplete documentation of any of those elements is the fastest route to a denial.

This reference guide covers the code definition, clinical indications, and accepted ICD-10 pairings. It also covers Medicare fee schedule rates, modifier usage, documentation requirements, and the errors that most often trigger rejections.

CPT Code 93925: Definition and code description

CPT Code 93925 describes a duplex scan of lower extremity arteries or arterial bypass grafts, complete bilateral study. The descriptor is maintained by the American Medical Association (AMA) CPT Editorial Panel.

The procedure uses real-time ultrasound to evaluate blood flow through both legs, and it relies on three imaging components.

• B-mode imaging – grayscale structural visualization of the arterial anatomy
• Doppler spectral waveform analysis – flow velocity measurement at each vessel segment
• Color flow mapping – directional blood flow visualization through both limbs

All three components must be performed and documented for the claim to meet medical necessity standards. A scan that omits color flow mapping, for example, does not satisfy the full descriptor and should not be billed as CPT Code 93925.

CPT 93925 quick reference

Use this table as an at-a-glance reference before building a claim for CPT Code 93925.

Clinical indications and medical necessity

Coverage for CPT Code 93925 is driven by Local Coverage Determinations (LCDs) issued by individual Medicare Administrative Contractors (MACs). Because LCD criteria vary by jurisdiction, always verify the applicable LCD before billing. These clinical indications are broadly accepted across most MAC policies.

• Peripheral arterial disease (PAD) evaluation – symptoms of lower limb ischemia including intermittent claudication, rest pain, or tissue loss
• Non-healing wounds – ulcers or wounds on the lower extremities where arterial insufficiency is suspected
• Pre-operative vascular assessment – mapping arterial anatomy before bypass surgery or endovascular intervention
• Post-operative or graft surveillance – monitoring arterial bypass grafts for patency after surgery
• Suspected arterial occlusion or stenosis – acute or chronic limb ischemia evaluation
• Ankle-brachial index (ABI) follow-up – further characterization of abnormal ABI findings

The Centers for Medicare & Medicaid Services (CMS) requires that the ordering provider’s documentation clearly state the clinical indication. A referral that lists only “leg pain” without connecting it to vascular pathology is a common reason for medical necessity denials.

CPT 93925 vs 93926: Bilateral vs unilateral

Choosing between CPT Code 93925 and its sibling code 93926 depends entirely on the scope of the study performed. Billing 93925 when only one limb was evaluated is the single most common audit trigger for vascular duplex claims.

Related vascular CPT codes

CPT Code 93925 sits within a family of non-invasive vascular study codes. Knowing the adjacent codes helps coders select the right one and avoid unbundling issues.

ICD-10 codes that support medical necessity

Pairing CPT Code 93925 with an accepted ICD-10 diagnosis code is a prerequisite for demonstrating medical necessity. The codes below are commonly accepted across most MAC LCD policies for this procedure. Payer-specific acceptance varies, so confirm the applicable LCD before billing.

Exclusion notes decide several of these pairings, and they change between subcategories. Look each diagnosis up in the ICD-10-CM code set before you attach it to a 93925 claim.

Medicare fee schedule and RVUs

Medicare payment for CPT Code 93925 varies by geographic location and MAC jurisdiction. It also depends on whether the claim is billed globally, under modifier 26, or under modifier TC. The CMS Physician Fee Schedule lookup tool provides current rates by locality.

The 2026 non-facility rate reflects a total of 7.11 RVUs at the $33.4009 conversion factor. For RVU-based calculations of your own, the FastRVU 2026 lookup tool pulls current CMS work, practice expense, and malpractice components.

Rates above are approximate national averages based on CMS data. Verify current rates using the CMS fee schedule lookup or FastRVU before submitting claims. Medicare reports its payment decisions and adjustment codes back to providers on 835 electronic remittance advice files.

Which modifier to append

Selecting the correct modifier for CPT Code 93925 determines whether a claim pays at the global, professional, or technical rate. Applying the wrong modifier is one of the top audit triggers for vascular duplex billing. Use the decision guide below to route each claim correctly.

The two decisions run in sequence, code first and modifier second. The chart below routes a finished study to one code and one modifier.

Documentation requirements

Incomplete documentation is the leading cause of medical necessity denials for vascular duplex studies. Capturing the required elements at the point of care beats reconstructing a record during an audit. Every CPT Code 93925 claim requires the following.

• Ordering provider documentation – written order with a clear clinical indication referencing vascular pathology, not just “leg pain”
• Bilateral confirmation – report must explicitly state that both lower extremities were evaluated
• B-mode imaging performed and documented – grayscale structural imaging of bilateral lower extremity arterial anatomy
• Doppler spectral waveform analysis – flow velocity measurements and waveform morphology documented for each vessel segment
• Color flow mapping – color Doppler imaging confirming directional blood flow through both limbs
• Interpreting physician signature – final report signed by a qualified interpreting physician
• Finalized report in the medical record – the report must be completed and available. Preliminary reads are not sufficient for claim submission

According to CMS LCD guidance, the report must document the specific vessels evaluated and the waveform findings at each level. It must also note any areas of stenosis or occlusion. A report that states only “bilateral lower extremity duplex completed, normal” without vessel-level detail is considered insufficient documentation by many MACs.

Common billing mistakes and how to avoid claim denials

Vascular duplex claims carry a higher-than-average denial rate. The bilateral requirement and the documentation checklist create several failure points in one claim. The most frequent errors for CPT Code 93925 are below.

Submitting a clean claim from the outset reduces the rework burden on billing teams. The CARC and RARC codes on an 835 remittance file tell you which of the errors above a payer found.

Payer-specific coverage policies

Medicare coverage for CPT Code 93925 is governed by MAC-issued Local Coverage Determinations, not a single national policy. Coverage indications, frequency limits, and documentation requirements vary between MACs. Two practices in different states may face different LCD criteria for the same code.

• Search the AAPC CPT lookup tool to cross-reference 93925 with LCD articles by MAC region
• Commercial payers (UnitedHealthcare, Aetna, BCBS plans) often align with Medicare LCD criteria but may impose additional pre-authorization requirements
• Some payers require a documented abnormal ABI result before authorizing a duplex study. Check the applicable payer policy before scheduling
• Frequency limits vary: some MACs allow one bilateral study per rolling 12 months for stable PAD patients

The Society for Vascular Surgery and the American Institute of Ultrasound in Medicine publish clinical practice guidelines for these studies. Those guidelines can support a medical necessity argument on appeal when a payer denies a 93925 claim.

How practice management software supports 93925 billing

A vascular practice billing 50 or more duplex studies a month runs into a compounding problem. Small errors at the documentation stage surface as denial backlogs weeks later, once the original encounter context is gone. Catching them before claims leave the system is what keeps reimbursement predictable.

Practice management software like Pabau integrates with Claim.MD, our US clearinghouse partner, to route claims to thousands of US payers via 837P electronic submissions.

The integration also supports real-time eligibility checks before a study is performed. Staff can confirm coverage and pre-authorization rules for the patient’s payer and locality before the appointment.

Pabau’s claims management software lets billing teams attach supporting ICD-10 codes directly to a procedure, apply modifiers, and review documentation checklists before submission. Electronic remittance advice arrives as 835 ERA files, so denial reason codes appear in the same system that submitted the claim. That cuts the lookup time on every denial.

See how Pabau handles vascular billing

From eligibility checks to ERA-based denial tracking, Pabau’s claims workflow is built for practices billing complex procedure codes like 93925. Book a demo to see it in action.

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Conclusion

Billing errors for CPT Code 93925 almost always trace back to one of two sources. Either a unilateral study was billed as bilateral, or the report failed to confirm all three imaging components. Both are fixable at the point of care rather than in the appeals queue.

The practical move is to make that check part of the scan itself. If the technologist cannot sign off on bilateral coverage and all three components, the claim should not go out as 93925.

Practices that hold the line there spend far less of the month reworking denials. Book a demo to see how Pabau flags an incomplete 93925 claim before it reaches the payer.

Continue your research

Need a clearinghouse that reaches thousands of US payers? Claim.MD vs Office Ally compares the two leading clearinghouse options for practices submitting vascular and specialty claims.

Want to reduce denial rates across your practice? 837 file submission guide explains how electronic claim files work and where common formatting errors trigger rejections.

Researching billing software options for a vascular or specialty practice? Best medical billing software in the US reviews the leading platforms with a focus on claims accuracy and clearinghouse integration.

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