M1383 Acute Peripheral Vascular Disease | HCPCS Reimbursement | OpenPayer

Summary & Overview

HCPCS M1383: Acute Peripheral Vascular Disease Assessment

HCPCS Level II code M1383 denotes services for acute peripheral vascular disease (acute PVD), covering assessment and treatment delivered in outpatient vascular clinics, emergency departments, and procedural vascular settings. This code matters nationally because acute peripheral vascular conditions can require timely diagnosis and intervention to prevent limb loss and other serious complications, making accurate coding essential for clinical communication and claims processing.

Key payers included in this summary are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of what M1383 represents, the common sites of service, and the national relevance of coding for acute PVD. The publication outlines typical billing context and what to expect from payer coverage patterns at a national level; it also highlights benchmarks and policy considerations relevant to billing and reimbursement for acute vascular services.

This analysis provides clinical context for M1383, explains probable service delivery settings, and summarizes the scope of payers in the review. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareM1383HCPCS Level IIperipheral vascular diseasevascular assessmentacute PVDoutpatient vascular careemergency vascular care

Billing Code Overview

HCPCS Level II code M1383 is described as Acute pvd, indicating services related to acute peripheral vascular disease. The service type is vascular assessment and treatment for acute peripheral vascular conditions. The typical site of service is outpatient vascular clinics, emergency departments, and vascular surgery or interventional radiology settings where acute peripheral vascular care is provided.

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 68-year-old male with a history of hypertension, hyperlipidemia, and long-standing smoking presents to a vascular surgery clinic with progressive intermittent claudication of the left calf and an ankle-brachial index (ABI) of 0.55. Noninvasive arterial duplex demonstrates an occlusive lesion in the left superficial femoral artery consistent with acute-on-chronic peripheral vascular disease. The clinician documents symptoms, performs a focused vascular exam, orders baseline labs and noninvasive imaging, and schedules an urgent endovascular evaluation. The procedural workflow includes pre-procedure consent and optimization, percutaneous arterial access in an angiography suite or hybrid operating room, diagnostic angiography to map the lesion, potential angioplasty with or without stent placement, intraprocedural heparinization, vascular closure, immediate post-procedure monitoring in a recovery area, and follow-up wound/vascular clinic visits to assess limb perfusion and wound healing. Typical sites of service are the hospital outpatient angiography suite, ambulatory surgery center, or inpatient operating room for cases requiring general anesthesia or complex revascularization.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work required is substantially greater than typically required, documented with supporting operative report.

HCPCS Level II M1381: Secondary Stroke Within 5 Days of Procedure

HCPCS-M1259-DIALYSIS-PATIENT-STATUS-FIRST-YEAR

HCPCS M1259: Patient Status Documented Within First Year of Dialysis

HCPCS-M1469-HEPATITIS-B-HISTORY-OR-POSITIVE-HEPATITIS-B-TEST

HCPCS Level II M1469: Hepatitis B History or Positive Hepatitis B Test

HCPCS-M1412-METASTATIC-NSCLC-TARGETED-THERAPY-EGFR-ALK-ROS1-BRAF-NTRK-MET-RET

HCPCS M1412: Metastatic NSCLC with Targetable Genomic Alterations

HCPCS-M1348-PAM-SCORE-INCREASE-EXCELLENT

HCPCS M1348: Patient Activation Measure Increase, Excellent

HCPCS-M1329-POST-OPERATIVE-ACUTE-PVD-EYE-ENCOUNTER

HCPCS M1329: Post-Operative Encounter for Acute Posterior Vitreous Detachment

HCPCS-M1502-PODIATRY-MIPS-VALUE-PATHWAY

HCPCS M1502: Podiatry MIPS Value Pathway

HCPCS-M1351-SUICIDE-SAFETY-PLAN-INITIATION-AND-REVIEW

HCPCS M1351: Suicide Safety Plan Initiation and Follow-up

HCPCS-M1274-SNF-ADMISSION-MONTHLY-EVALUATION-EXCLUSION

HCPCS Level II M1274: SNF Admission Monthly Evaluation Exclusion

HCPCS-M1408-GERMLINE-BRCA-TESTING-BEFORE-OVARIAN-CANCER-DIAGNOSIS

HCPCS M1408: Germline BRCA Testing Before Ovarian Cancer Diagnosis

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Taxonomy Code	Specialty	Notes
`208D00000X`	Vascular Surgery	Primary specialty performing open and endovascular peripheral vascular interventions.
`207L00000X`	Interventional Cardiology	Frequently performs peripheral endovascular procedures in select centers.
`208000000X`	General Surgery	Performs peripheral vascular bypass and open revascularization procedures.
`173C00000X`	Interventional Radiology	Performs diagnostic angiography and endovascular interventions for peripheral vascular disease.
`364S00000X`	Vascular Medicine	Provides pre- and post-procedure management and noninvasive vascular testing.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I70.213`	Atherosclerosis of native arteries of extremities with intermittent claudication, left leg	Represents a common cause of acute-on-chronic peripheral vascular disease presenting with claudication and target for revascularization.
`I70.233`	Atherosclerosis of native arteries of extremities with rest pain, left leg	Indicates more severe limb ischemia prompting urgent intervention.
`I70.241`	Atherosclerosis of native arteries of extremities with ulceration, left leg	Shows tissue loss/ulceration requiring revascularization to promote healing.
`I70.261`	Atherosclerosis of native arteries of extremities with gangrene, left leg	Represents critical limb ischemia with high urgency for revascularization or amputation prevention.
`I73.9`	Peripheral vascular disease, unspecified	General diagnosis code used when specifics of disease severity or laterality are not fully documented.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`37220`	Revascularization, endovascular, open or percutaneous, femoral, popliteal, tibial, including angioplasty when performed; single vessel	Commonly performed for focal superficial femoral artery lesions during endovascular treatment for peripheral vascular disease.
`37224`	Revascularization, endovascular, tibial/peroneal, single vessel	Used when tibial vessel angioplasty/stenting is required as part of limb revascularization following diagnostic angiography.
`37226`	Revascularization, endovascular, percutaneous, complete multi-vessel	Applied when multiple peripheral arterial segments are treated in the same setting.
`75962`	Angiography, extremity, unilateral, radiological supervision and interpretation	Used for diagnostic peripheral angiography performed before or during the revascularization procedure.
`36140`	Arterial catheterization or cannulation for selective catheter placement, percutaneous	Used to report arterial access or catheter introduction into the peripheral arterial system prior to angiography or intervention.

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