CPT Code 93975: Duplex scan of arterial inflow and venous outflow of abdomen, retroperitoneum, scrotal contents, and/or pelvic organs (complete study)

What is a duplex scan of abdominal, retroperitoneal, and pelvic circulation?

A duplex scan of these areas is a noninvasive vascular diagnostic test that evaluates the structure and function of blood vessels using real-time ultrasound combined with spectral and color Doppler. It enables clinicians to detect vascular abnormalities such as narrowing (stenosis), blockages (thrombosis), aneurysms, abnormal flow patterns, or reflux in the veins.

The exam includes visualization of the abdominal aorta, renal arteries and veins, iliac vessels, inferior vena cava, portal and hepatic veins, as well as vessels in the scrotum (e.g., testicular artery, pampiniform plexus) and pelvis (e.g., ovarian veins, uterine arteries, internal iliac vessels). These scans are widely used in vascular medicine, nephrology, and urology.

CPT code 93975 documentation requirements

Because CPT 93975 represents a complete vascular study, comprehensive documentation is required to support medical necessity and accurate coding:

Detailed ultrasound report

The report must confirm that both arterial inflow and venous outflow were evaluated. It should name the vessels scanned (e.g., renal arteries, testicular veins, portal vein), describe flow patterns (direction, velocity, turbulence), and note any anatomical or pathological findings.

Doppler waveforms, grayscale images, and interpretations must be included in the final report.

Clinical indications

Clearly document the medical necessity for the duplex scan. Common indications include abdominal bruit, suspected vascular occlusion, uncontrolled hypertension (to assess for renal artery stenosis), scrotal pain or swelling (for varicocele or hydrocele), and pelvic pain (for ovarian torsion or pelvic congestion). Symptoms, physical findings, and relevant history should all be included.

Exam completeness

The record must support that this was a complete study, meaning both arterial and venous systems were evaluated in all applicable regions.

If only one vascular system or part of the region is examined, CPT 93976 (limited study) must be used instead.

CPT code 93975 billing guidelines

Accurate billing for CPT 93975 depends on whether the full vascular territories were assessed. Use the following guidance:

Use only when both arterial and venous systems are evaluated

CPT 93975 is valid only when both the arterial inflow and venous outflow of the abdomen, retroperitoneum, scrotum, and/or pelvic organs are assessed. If the study is limited in scope or omits one vascular system, report CPT 93976 instead.

Separate billing for components

If the technical and professional components are billed separately:

• Use modifier 26 for the professional interpretation only.
• Use modifier TC for the technical portion (equipment, technician, etc.).
• No modifier is needed for global billing when both are provided by the same entity.

Frequency and prior authorization

Some payers require prior authorization or limit the frequency of complete duplex exams. Confirm payer-specific coverage guidelines before scheduling repeat studies, especially for chronic conditions or follow-up imaging.

Applicable modifiers for CPT 93975

The following modifiers may be used with CPT 93975 to clarify billing scenarios:

• 26: Professional component only (interpretation and report)
• TC: Technical component only (performance and equipment use)
• 59: Distinct procedural service, when performed in a separate session or on a different vascular territory during the same encounter

Related CPT codes

• 93976: Duplex scan of abdominal, retroperitoneal, scrotal, or pelvic vessels, limited study
• 93978: Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study
• 93979: Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study