691_cerebrovascular_and_peripheral_arterial_venous_studies
Defines medical necessity, investigational and not medically necessary indications for a range of noninvasive vascular studies (extracranial cerebrovascular arterial studies, transcranial Doppler, peripheral arterial and venous examinations, visceral vascular studies, hemodialysis access evaluations, and vessel mapping) for Commercial members and related products; includes prior authorization guidance and associated CPT/ICD code lists (partial).
10/2024: Policy revised to include medically necessary and investigational indications for Cerebrovascular arterial studies (extracranial and transcranial doppler) codes 93880, 93882, 93886, 93888, 93890, 93892, and 93893. Effective 10/1/2024.
Multiple entries noting 'Clarified coding information' across 2024-2025 and prior years.
References to LCD L33627 and Billing and Coding A56758 were provided with last update date 6/19/2020.