January 27, 2014, Medicare covers AAA screening for eligible beneficiaries without requiring them to receive a referral as part of the Initial Preventive Physical Examination (IPPE, also commonly known as the “Welcome to Medicare Preventive Visit”).
Full Answer
How often should AAA screening be done?
The U.S. Preventive Services Task Force (USPSTF) recommends one-time screening for abdominal aortic aneurysm (AAA) with ultrasonography in men ages 65 to 75 years who have ever smoked ( Table 1). B recommendation. Table 1. Screen once for abdominal aortic aneurysm (AAA) by ultrasonography. Selectively screen for AAA. No recommendation.
When to screen for AAA?
Screening for Abdominal Aortic Aneurysm: Recommendation Statement
- Summary of Recommendations. 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).
- Importance. An AAA is typically defined as aortic enlargement with a diameter of 3.0 cm or larger. ...
- USPSTF Assessment of Magnitude of Net Benefit. ...
What is the treatment for AAA?
Treatment of abdominal aortic aneurysms (AAAs) consists of surgical repair. When indicated, an unruptured aneurysm can undergo elective surgical repair; a ruptured AAA calls for emergency repair.
How to screen for AAA?
Your doctor may recommend this test if you have a problem in any of these body areas:
- Blood vessels in the abdomen
- Gallbladder
- Intestines
- Kidneys
- Liver
- Pancreas
- Spleen
What is AAA screening for?
Abdominal aortic aneurysm (AAA) screening is a way of checking if there's a bulge or swelling in the aorta, the main blood vessel that runs from your heart down through your tummy. This bulge or swelling is called an abdominal aortic aneurysm, or AAA.
What diagnosis will cover AAA screening?
Abdominal aortic aneurysm screenings covers an abdominal aortic screening ultrasound once if you're at risk. 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.
What does AAA mean in healthcare?
An abdominal aortic aneurysm is also called AAA or triple A. A thoracic aortic aneurysm refers to the part of the aorta that runs through the chest. Once formed, an aneurysm will gradually increase in size and get progressively weaker.
Does Medicare pay for aortic ultrasound?
Medicare Part B covers a one-time AAA ultrasound if you are at risk for AAA and receive a referral from your provider. Medicare considers you at risk for AAA if: You have a family history of AAA.
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. If you are at risk, don't put off talking to a doctor about steps you can take to protect your health.
What are symptoms of aortic aneurysm?
Signs and symptoms that a thoracic aortic aneurysm has ruptured or dissected include:Sharp, sudden pain in the upper back that spreads downward.Pain in the chest, jaw, neck or arms.Difficulty breathing.Low blood pressure.Loss of consciousness.Shortness of breath.Trouble swallowing.
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.
How often should AAA be monitored?
Aneurysms smaller than five centimeters in diameter are typically monitored with ultrasound or CT scans every six to 12 months. Larger aneurysms or those that are quickly growing or leaking may require open or endovascular surgery.
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.
When should screening for AAA be considered?
The USPSTF recommends 1-time screening for abdominal aortic aneurysm (AAA) with ultrasonography in men aged 65 to 75 years who have ever smoked.
How do you bill AAA screening?
CPT® code 76706: Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA) Short Descriptor: Us abdl aorta screen AAA.
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)].
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 happens if AAA is undetected?
If the AAA remains undetected, the aortic wall continues to weaken, and the aneurysm continues to grow. Eventually, the aneurysm becomes so large and its wall so weak that a rupture occurs. When this happens, there is massive internal bleeding, a situation that is often fatal.
Does Medicare pay for AAA screening?
Medicare will pay for a one-time AAA Screening for first time Medicare recipients that qualify for the benefit. The screening uses an ultrasound to detect bulging in the aorta. Once an aneurysm is detected, it can be treated by medical experts.
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 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.
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.
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.
