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.
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 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.
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.
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 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.
What is AAA ultrasound?
What is a AAA Ultrasound? This safe and painless non-invasive screening uses ultrasound to look for an abdominal aortic aneurysm. Sound waves create a picture of the abdominal aorta to measure its width and find out whether there is a bulge, which may indicate the presence of an aneurysm.
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.
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.
Can blood test detect aortic aneurysm?
A Simple Blood Test, Such as Complete Blood Count, Can Predict Calcification Grade of Abdominal Aortic Aneurysm.
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.
What is AAA in the body?
An AAA is what we call it when the aorta—the largest artery in your body—balloons in your abdomen. It usually happens in people over 50 due to plaque building up over time, but it can also be caused by injury or infection. The biggest issue with AAA is that if it's left untreated, it might eventually rupture.
What is an aortic aneurysm?
An abdominal aortic aneurysm is a non-invasive procedure that tests your heartbeat for irregularities. Getting screened for an abdominal aortic aneurysm (AAA) may not be at the top of your priority list, but it turns out what you don't know actually can hurt you, especially when it comes to AAAs.
What is life line screening?
At Life Line Screening, we have years of experience helping people prevent major medical issues with vital early detection services, including AAA screenings. In fact, screenings are our specialty. We partner with community centers to help people get quick, easy access to the screenings they want to stay on top of their health. No lengthy doctor's visits, no complicated insurance to deal with, just convenient screenings for health-conscious people conducted by trained professionals.
What is a screening machine?
A screening is performed by a trained sonographer, which is someone who uses an ultrasound machine to gather information about the inside of your body , as is done for pregnant women. The sonographer has you lie on your back and then takes a quick scan of your abdomen.
Can an aortic aneurysm affect your day to day?
While an AAA is definitely something you want to be aware of, it often doesn't actually affect your day- to-day. The problem is more about the risk it presents for the future than the aneurysm itself.
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.
How to detect AAA?
The primary way of screening for AAA is with an abdominal ultrasound. This screening test is easy to perform, noninvasive, does not involve radiation, and is highly accurate in detecting AAA. The potential benefit of screening for AAA is detecting and repairing it before rupture, which requires emergency surgery and has a high mortality rate. The only potential harm of screening is related to the risks of surgical repair such as bleeding complications and death.#N#The U.S. Preventive Services Task Force recommendation applies to adults aged 50 years or older who do not have any signs or symptoms of AAA. Early detection of AAA can save lives.#N#Based on current evidence, the USPSTF concludes with moderate certainty that screening for AAA in men aged 65 to 75 years who have ever smoked is of moderate net benefit, even if they have no symptoms. For men aged 65 to 75 years who have never smoked, the USPSTF concludes with moderate certainty that screening is of small net benefit, and should be offered selectively based on medical history and risk factors. There is sufficient evidence that there is no net benefit of screening women who have never smoked and have no family history of AAA. For women aged 65 to 75 years who have ever smoked or have a family history of AAA, there is not enough evidence to adequately assess the balance of benefits and harms of screening for AAA.
What are the risk factors for AAA?
Risk factors for AAA include being male, older, a smoker or former smoker, and having a first-degree relative with AAA. Other risk factors include a history of other vascular aneurysms, coronary artery disease, cerebrovascular disease, and hypercholesterolemia.
What causes an aortic aneurysm?
A number of factors can play a role in the development of an aortic aneurysm, including: 1 Atherosclerosis (hardening of the arteries) – occurs when fat and other substances build up on the lining of a blood vessel. 2 Hypertension – High blood pressure can damage and weaken the walls of the aorta. 3 Blood vessel diseases – Cause the blood vessels to become inflamed. 4 Infection of the aorta – Rarely, bacterial or fungal infection causes AAA. 5 Trauma
What is the risk of a ruptured aneurysm?
Although the risk for rupture varies greatly by aneurysm size, the associated risk for death with rupture is as high as 81 percent. This is why it is imperative to screen those at risk, and once diagnosed, the size of a patient’s AAA should be monitored periodically.
How big is the aorta?
In an adult, the abdominal aorta is typically about two centimeters in diameter. The definition of AAA is a focal dilation of the abdominal aorta such that the diameter is greater than 3 cm or more than 50 percent larger than normal.
What causes AAA in the aorta?
Hypertension – High blood pressure can damage and weaken the walls of the aorta. Blood vessel diseases – Cause the blood vessels to become inflamed. Infection of the aorta – Rarely, bacterial or fungal infection causes AAA. Trauma.
Is smoking a risk factor for an aortic aneurysm?
Smoking is the strongest predictor of AAA prevalence, growth, and rupture rates. There is a dose-response relationship, as greater smoking exposure is associated with an increased risk for AAA. Most aortic aneurysms do not cause symptoms until they rupture, which is why they are so dangerous.
