DUPLEX SCAN OF EXTRACRANIAL ARTERIES - Oxford Health Plans

Other complications of internal (biological) (synthetic) prosthetic996.74device, implant and graft, due to other vascular device, implant, andgraftOther complications of internal (biological) (synthetic) prosthetic996.75device, implant and graft, due to nervous system device, implant, andgraftOther complications of internal (biological) (synthetic) prosthetic996.76device, implant and graft, due to genitourinary device, implant, andgraftOther complications of internal (biological) (synthetic) prosthetic996.77device, implant and graft, due to internal joint prosthesisOther complications of internal (biological) (synthetic) prosthetic996.78device, implant and graft, due to other internal orthopedic device,implant and graftOther complications of internal (biological) (synthetic) prosthetic996.79device, implant and graft, due to other internal prosthetic device,implant and graftPersonal history of transient ischemic attack [TIA], and cerebralV12.54infarction without residual deficitsV45.89 Other postprocedural status (use for post carotid stent placement)ICD-10 Codes (Preview Draft)In preparation for the transition from ICD-9 to ICD-10 medical coding on October 1, 2014 * , asample listing of the ICD-10 CM and/or ICD-10 PCS codes associated with this policy has beenprovided below for your reference. This list of codes may not be all inclusive and will be updatedto reflect any applicable revisions to the ICD-10 code set and/or clinical guidelines outlined in thispolicy. *The effective date for ICD-10 code set implementation is subject to change.ICD-10 Diagnosis CodeDescription(Effective 10/01/14)G04.1 Tropical spastic paraplegiaG45.0 Vertebro-basilar artery syndromeG45.1 Carotid artery syndrome (hemispheric)G45.2 Multiple and bilateral precerebral artery syndromesG45.3 Amaurosis fugaxG45.4 Transient global amnesiaG45.8 Other transient cerebral ischemic attacks and related syndromesG45.9 Transient cerebral ischemic attack, unspecifiedG46.0 Middle cerebral artery syndromeG46.1 Anterior cerebral artery syndromeG46.2 Posterior cerebral artery syndromeG81.01 Flaccid hemiplegia affecting right dominant sideG81.02 Flaccid hemiplegia affecting left dominant sideG81.03 Flaccid hemiplegia affecting right nondominant sideG81.04 Flaccid hemiplegia affecting left nondominant sideG81.11 Spastic hemiplegia affecting right dominant sideG81.12 Spastic hemiplegia affecting left dominant sideG81.13 Spastic hemiplegia affecting right nondominant sideG81.14 Spastic hemiplegia affecting left nondominant sideG81.91 Hemiplegia, unspecified affecting right dominant sideG81.92 Hemiplegia, unspecified affecting left dominant sideG81.93 Hemiplegia, unspecified affecting right nondominant sideG81.94 Hemiplegia, unspecified affecting left nondominant sideG82.20 Paraplegia, unspecifiedG82.21 Paraplegia, completeG82.22 Paraplegia, incompleteG82.50 Quadriplegia, unspecifiedDuplex Scan of Extracranial Arteries: Clinical Policy (Effective 11/01/2012)©1996-2012, Oxford Health Plans, LLC5