Medicare Part B also covers a one-time abdominal aortic ultrasound examination to screen for the condition. You must have one of the following risk factors to be eligible: You have a family history of aortic aneurysm You’re a male 65 to 75 years old who has smoked at least 100 cigarettes
Full Answer
Does Medicare cover abdominal aortic aneurysm screening?
Abdominal aortic aneurysm (AAA) screening. This means you pay nothing (no deductible or coinsurance ). Medicare Advantage Plans are required to cover a one-time AAA ultrasound without applying deductibles, copayments, or coinsurance when you see an in-network provider and meet Medicare’s eligibility requirements for the service.
How to diagnose an abdominal aortic aneurysm?
Diagnosis 1 Abdominal ultrasound. This test is most commonly used to diagnose abdominal aortic aneurysms. 2 CT scan. This painless test can provide your doctor with clear images of your aorta,... 3 MRI. In this test, you lie on a movable table that slides into a machine.
What is the goal of abdominal aortic aneurysm treatment?
The goal of abdominal aortic aneurysm treatment is to prevent an aneurysm from rupturing. Treatment may involve careful monitoring or surgery. Which treatment you have depends on the size of the aortic aneurysm and how fast it's growing.
What diagnosis will cover AAA screening?
Abdominal aortic aneurysm screenings You're considered at risk if you have a family history of abdominal aortic aneurysms, or you're a man 65-75 and have smoked at least 100 cigarettes in your lifetime.
When should an abdominal aortic aneurysm be checked?
The USPSTF recommends 1-time screening for abdominal aortic aneurysm (AAA) with ultrasonography in men aged 65 to 75 years who have ever smoked (Table 1).
What is the indication for aortic aneurysm surgery?
The indications for repair of abdominal aortic aneurysm (AAA) are discussed in detail elsewhere and include symptomatic aneurysm of any size (eg, abdominal, back or flank pain, evidence of embolization, frank rupture), asymptomatic aneurysm ≥5.5 cm in men and >5.0 cm in women [3,4], rapidly expanding AAA, AAA ...
How often should you be screened for abdominal aortic aneurysm?
You'll be invited back for a scan every 3 months to check its size. Treatment will usually only be needed if it becomes a large AAA. You'll also be given advice on how you can stop an AAA getting bigger, such as stopping smoking, eating healthily and exercising regularly.
What ICD 10 code covers AAA screening?
The ICD-10-CM code to support AAA screening is Z13. 6 Encounter for screening for cardiovascular disorders [abdominal aortic aneurysm (AAA)].
How do you get tested for an aneurysm?
A brain aneurysm is usually diagnosed using angiography. Angiography is a type of X-ray used to check blood vessels. This involves inserting a needle, usually in the groin, through which a narrow tube called a catheter can be guided into one of your blood vessels.
What is the most common cause of abdominal aortic aneurysm?
Smoking is the most common cause of an abdominal aortic aneurysm as well as many other health problems. Exercising daily can also be beneficial, as can lifestyle changes that help lower your blood pressure.
What size abdominal aortic aneurysm requires surgery?
Surgery is commonly advised if you develop an AAA larger than 5.5cm in maximum diameter (about 5 cm in women). For these larger aneurysms the risk of rupture is usually higher than the risk of surgery.
How large does an aortic aneurysm have to be for surgery to be recommended immediately?
If the aneurysm is more than 5.5 centimeters in size, or if it's rapidly getting larger, your doctor may recommend surgery to repair the aneurysm.
Are there any warning signs of an aortic aneurysm?
5 warning signs and symptoms that aortic aneurysm might be suspected include: 1) Chest tenderness or chest pain, dizziness or light-headedness, back pain, coughing up blood (hemoptysis) and loss of consciousness due to the ruptures.
Why would you need an aorta ultrasound?
Why is an aortic ultrasound done? Your doctor may recommend that you have an aortic ultrasound if you're at risk of an abdominal aortic aneurysm. A one-time abdominal aortic ultrasound screening is recommended for men between the ages of 65 and 75 who have smoked at least 100 cigarettes during their lifetimes.
Why do I need an abdominal aorta ultrasound?
An abdominal ultrasound can help your doctor evaluate the cause of stomach pain or bloating. It can help check for kidney stones, liver disease, tumors and many other conditions. Your doctor may recommend that you have an abdominal ultrasound if you're at risk of an abdominal aortic aneurysm.
What are the risk factors for an aortic aneurysm?
The CDC lists the following risk factors for aortic aneurysm: A history of smoking or tobacco use. Atherosclerosis, or hardening of the arteries. High blood pressure. Infection. Family history and genetic factors, such as Marfan syndrome and Ehlers-Danlos syndrome.
What causes aortic aneurysms?
These aneurysms occur in the chest and are equally common in both men and women; the risk increases with age. Most thoracic aortic aneurysms are caused by high blood pressure or sudden injury, but hereditary diseases of the connective tissue such as Ehlers-Danlos syndrome or Marfan syndrome can also cause them, the CDC reports.
What is the name of the artery that carries blood away from the heart and into the rest of the body?
An aortic aneurysm is a bulging or ballooning of the aorta, which is the main artery that carries blood away from the heart and into the rest of the body, according to the National Institutes of Health’s Medline Plus. There are two main types of aortic aneurysm: thoracic and abdominal.
Can an aortic aneurysm cause high blood pressure?
The National Institutes of Health (NIH) says that if your thoracic or abdominal aortic aneurysm is small and not causing any symptoms, your doctor may recommend regular medical monitoring and treatment of any conditions such as high blood pressure or atherosclerosis that may cause your aneurysm to worsen.
Can an aortic aneurysm be caused by infection?
These tend to occur mainly in people with atherosclerosis, although injury and infection can also cause an abdominal aortic aneurysm. Often, they have no obvious symptoms, but signs may include:
Can you have no symptoms of an aortic aneurysm?
The National Institutes of Health notes that one of the dangers of aortic aneurysm is that you might have no symptoms at all. If present, the symptoms of aortic aneurysm may be different for each type, according to the CDC.
Can an aneurysm cause internal bleeding?
This is called a dissection. The aneurysm can burst completely, causing severe internal bleeding. This is called a rupture.
What is an aortic aneurysm?
Abdominal aortic aneurysm (AAA) is a ballooning of the aorta, a large blood vessel that supplies blood to your body. When left untreated, aortic ruptures can cause life-threatening internal bleeding. Screening can help determine if you need medical treatment for AAA.
Does Medicare cover AAA ultrasound?
Keep in mind that Medicare only covers the AAA ultrasound once in your lifetime. If your provider suggests that you receive a second AAA ultrasound, Medicare may deny coverage. This means you would be responsible for the full cost of the service.
What is an AAA in Medicare?
Hundreds of thousands of Americans who receive Medicare benefits have access to an important health screening tool for fighting vascular disease: a free abdominal aortic aneurysm (AAA) screening for Medicare beneficiaries.
How many people have abdominal aneurysms?
As noted by the Society of Vascular Surgeons, 200,000 people in the U.S. are diagnosed with an abdominal aortic aneurysm (AAA) each year.
What is the name of the artery that goes from the heart to the kidneys?
An abdominal aortic aneurysm (also known as AAA) is a blood-filled bulge or ballooning of the aorta, which is the main artery that goes from your heart down to the chest, kidneys, intestines and other organs in the abdomen and pelvis.
How many people died from an aortic aneurysm in 2014?
Aortic aneurysms were the primary cause of 9,863 deaths in 2014 and a contributing cause in more than 17,215 deaths in the United States in 2009. Two-thirds (⅔) of people who have an aortic aneurysm are male. 1.5 to 2 million are estimated to have an undiagnosed AAA.
Why does my aorta balloon?
The ballooning in an artery is called an aneurysm and occurs due to the weakening of the artery’s wall. The bulge or “ballooning” of the artery may grow larger and over time, the force of normal blood pressure can cause the weakened aorta blood vessel to eventually tear or rupture if it is not diagnosed and treated.
Can I get an AAA screening with Medicare?
New Medicare Beneficiaries Can Get No-Cost AAA Screening. If you (or your loved one) have recently become eligible for Medicare, then you will be required to have a “Welcome to Medicare” preventive visit with your doctor. During the Welcome To Medicare visit, new Medicare beneficiaries may receive a referral for an Abdominal Aortic Aneurysm (AAA) ...
Does Medicare cover AAA ultrasound?
The one-time, FREE AAA ultrasound screening is for people who have never received Medicare coverage for AAA screenings and who are at risk for an abdominal aortic aneurysm.
General Information
CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.
Article Guidance
Once in a lifetime abdominal aortic aneurysm (AAA) screening is only covered under certain specified conditions. When billing for AAA screenings, the following ICD-10 codes should be billed: * Z13.6 for the encounter for screening for cardiovascular disorders and either ** The most appropriate code for tobacco usage: Z87.891, F17.210, F17.211, F17.213, F17.218 and F17.219 OR * Z84.89 for family history of other specified conditions Note: CPT® code 76706 is the only ultrasound service that is payable for AAA screening under Medicare services.
ICD-10-CM Codes that Support Medical Necessity
Palmetto GBA acknowledges that no current ICD-10 diagnosis code specifically describes the circumstance “ (II) is a man age 65 to 75 who has smoked at least 100 cigarettes in his lifetime;” as noted in the CMS Internet-Only Manual, Publication 100-04, Medicare Claims Processing Manual, Chapter 18, Section 110.2 and 110.3.2.
Bill Type Codes
Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type.
Revenue Codes
Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination.
What is an AAA in the abdomen?
AAA is a widening or bulging of the aorta (the largest blood vessel) in the abdomen. AAA usually occurs at a weak spot in the aortic wall. It often doesn’t cause any symptoms, but if the aneurysm widens rapidly it may cause abdominal pain which can be severe. If it bursts (ruptures) this can be fatal.
Can you have surgery for an aneurysm?
If you have a small aneurysm, surgery isn’t usually advised but you will need regular ultrasound checks to see if your aneurysm is expanding. It’s also important to manage your condition by changing your lifestyle and treat any condition that may be causing the aneurysm (such as high blood pressure).
Can AAA cause back pain?
AAA often causes no symptoms. However, if it starts to expand and push on surrounding tissue or nerves in your abdomen, it can cause abdominal pain and/or lower back pain.
What test can be used to diagnose an aortic aneurysm?
If your doctor suspects that you have an aortic aneurysm, specialized tests, such as the following, can confirm it. Abdominal ultrasound. This test is most commonly used to diagnose abdominal aortic aneurysms. You lie on a table while a technician moves a wand (transducer) around your abdomen.
What is the goal of treatment for an aortic aneurysm?
Treatment. The goal of treatment — either medical monitoring or surgery — is to prevent your aneurysm from rupturing. Which treatment you have depends on the size of the aortic aneurysm and how fast it's growing.
How to repair an aneurysm in the aorta?
Depending on several factors, including location and size of the aneurysm, your age, and other conditions you have, repair options might include: Open abdominal surgery. This involves removing the damaged section of the aorta and replacing it with a synthetic tube (graft), which is sewn into place.
What is a graft in an aneurysm?
The graft — a woven tube covered by a metal mesh support — is placed at the site of the aneurysm, expanded and fastened in place. It reinforces the weakened section of the aorta to prevent rupture of the aneurysm. Endovascular surgery isn't an option for about 30 percent of people with an aneurysm.
How big is an aneurysm?
Repair is generally recommended if your aneurysm is 1.9 to 2.2 inches (4 .8 to 5.6 centimeters) or larger or if it's growing quickly. Also, your doctor might recommend surgery if you have symptoms such as stomach pain or you have a leaking, tender or painful aneurysm.
What is CT scan?
CT scanning generates X-rays to produce cross-sectional images of your body. You might have contrast dye injected into your blood vessels that makes your arteries more visible on the CT pictures (CT angiography). MRI. In this test, you lie on a movable table that slides into a machine.
Does smoking increase the risk of an aortic aneurysm?
Being male and smoking significantly increase the risk of abdominal aortic aneurysm. Screening recommendations vary, but in general: Men ages 65 to 75 who have ever smoked cigarettes should have a one-time screening using abdominal ultrasound.
What is AAA in medical terms?
A thin, weak spot can balloon outward, forming an abdominal aortic aneurysm, or AAA. Most of these bulges remain small, grow slowly, and pose no serious danger. But a small number swell to two inches or greater in diameter and may rupture, usually without warning and with potentially fatal consequences. (The vessel is normally less ...
Which artery is the largest in the body?
The body's largest artery, the aorta, curves out of the heart down through the center of the body, where it branches into smaller arteries that send blood to various organs and the legs. Over a lifetime, the bottom section of this vessel — the abdominal aorta — may weaken.