Abdominal duplex scan assigned more than once on the same day

Q.

May an abdominal duplex scan (CPT^® 93975) be assigned more than once on the same day?

A.

The MUE (Medically Unlikely Edit) is one. It would not be expected to see this code assigned more than once as it includes any and all of the abdominal, retroperitoneal and/or scrotal organs. The MAI (MUE adjudication indicator) is three, so it can be over-ridden by the MAC (Medicare Administrative Contractor) if medical necessity was proven.

If, for instance, the patient’s condition significantly changed and another scan was required, then you could assign this code again. Excellent documentation of medical necessity would be required for a second exam.