Summary & Overview
CPT 9006F: Symptomatic Carotid Artery Stenosis within 120 Days
CPT code 9006F denotes documentation that a patient with carotid artery stenosis is symptomatic, defined by an ipsilateral transient ischemic attack or stroke within 120 days before a surgical procedure. This status influences clinical decision-making around timing and urgency of carotid interventions and is recognized across national payer programs and quality reporting frameworks. The code matters because accurate documentation of symptomatic status affects procedural planning, risk communication, and alignment with guideline-based care for stroke prevention.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of code intent and clinical context, an overview of typical sites of service for documentation, and references to the kinds of benchmarks and policy considerations that generally accompany performance measures and preoperative documentation codes. The report highlights how symptomatic designation within 120 days is used in perioperative evaluation and quality measurement, and it outlines where additional data may be needed for payer-specific coverage and billing rules.
Data not available in the input for payer-specific modifiers, taxonomies, ICD-10 code mappings, and related billing codes; those elements are indicated as unavailable where applicable.
Billing Code Overview
CPT code 9006F documents that a patient with carotid artery stenosis is symptomatic, with evidence of an ipsilateral transient ischemic attack or stroke within 120 days before a surgical procedure. This designation is used to capture clinical status relevant to timing and risk stratification for carotid intervention.
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Service type: Preoperative clinical status documentation related to carotid artery disease and cerebrovascular events
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Typical site of service: Vascular surgery clinic, neurology clinic, hospital preoperative assessment, or inpatient surgical services
Data not available in the input for payers, common modifiers, associated taxonomies, ICD-10 diagnoses, related codes, and service line.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 68-year-old man with known carotid artery atherosclerotic disease who presents to the vascular surgery clinic after sudden onset of right arm weakness and transient aphasia two weeks prior. Neurologic evaluation and carotid duplex ultrasound confirm a high-grade left internal carotid artery stenosis. Brain imaging (CT and MRI) excludes large established infarct and documents a small watershed ischemic event consistent with a transient ischemic attack. The vascular surgeon documents that the patient is symptomatic with an ipsilateral transient ischemic attack within 120 days before planned carotid endarterectomy.
The clinical workflow includes: outpatient neurologic and vascular evaluation, diagnostic vascular imaging (carotid duplex and CTA or MRA), preoperative medical optimization (antiplatelet therapy, blood pressure control), informed consent for carotid endarterectomy, perioperative anesthesia evaluation, the surgical procedure, and postoperative neurological monitoring and discharge planning.
Coding Specifications
- For this code the most applicable CMS modifiers and their common use cases are summarized below.
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure | Use when a separate E/M visit is medically necessary and documented on the same day as a procedure related to carotid disease. |