Abdominal Aorta
The aorta is the largest artery in the body and delivers the entire blood volume. The thoracic aorta arises from the left ventricle of the heart and supplies arterial blood to the organs and tissues of the head, upper extremities, and thorax before it arrives at the diaphragm. As it passes through the diaphragm, it becomes the abdominal aorta. The abdominal aorta gives of numerous branches to the abdominal organs and tissues before it divides into the left and right common iliac arteries at the level of the umbilicus.
Abdominal Aortic Disease
Abdominal aortic disease is a common result of atherosclerosis and can manifest as aortic stenosis, occlusion, embolization, or aneurysm formation.
An abdominal aortic aneurysm is an enlarged area in the lower part of the aorta, the major blood vessel that supplies blood to the body. Because the aorta is the body’s main supplier of blood, a ruptured abdominal aortic aneurysm can cause life-threatening bleeding.
It occurs due to weakness in the wall of the artery. Factors that can increase your risk of having the problem include:
- Smoking
- High blood pressure
- Male gender
- Genetic factors
An abdominal aortic aneurysm is most often seen in males over age 60 who have one or more risk factors. The larger the aneurysm, the more likely it is to break open or tear. This can be life-threatening.
Medicare Part B (Medical Insurance) covers a one-time abdominal aortic aneurysm ultrasound. You must get a referral for it from your doctor.
Who’s eligible?
People with Part B who are at risk. You’re considered at risk if you meet one of these criteria:
- You have a family history of abdominal aortic aneurysms.
- You’re a man age 65 to 75 and have smoked at least 100 cigarettes in your lifetime.
Your costs in original Medicare
You pay nothing for this test if the doctor or other qualified health care provider accepts assignment.
Healthcare Common Procedure Coding System (HCPCS) Level II code G0389, Ultrasound B-scan and/or real time with image documentation; for abdominal aortic aneurysm (AAA) screening will be deleted and replaced with CPT Category I code 76706.
NEW CODE- 76706 Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA) (For ultrasound or duplex ultrasound of the abdominal aorta other than screening, see 76770, 76775, 93978, 93979)
Medicare will pay for a one-time ultrasound screening for AAA for beneficiaries who meet certain conditions. The beneficiary need only obtain a referral from their physician, physician assistant, nurse practitioner, or clinical nurse specialist. There is no deductible or coinsurance.
Assign the code only for reporting ultrasound scan screening studies for abdominal aortic aneurysm (AAA)
The code is specific to screening for AAA. For ultrasound or duplex ultrasound of the abdominal aorta other than screening, CPT instructs to see 76770, 76775, 93978, and 93979.
Effective for dates of service on and after January 1, 2017, CPT code 76706 replaced HCPCS code G0389.
Dr. Santosh Kumar Guptha
All centers will begin using the HCPCS code G0389 for Medicare patients only who are being scheduled for a screening of abdominal aortic aneurysm (AAA) instead of the codes 76700 (abdominal u/s) or 76770 (renal/aortic u/s). I have attached a PDF regarding the standards and limitations of this code from CMS. Please follow these guidelines when scheduling:
- Is the test being ordered as a result of an IPPE (initial preventive physical exam), also known as the Welcome to Medicare program?
- Has the patient previously had one of these done before? (Medicare will only reimburse for one per lifetime)
- Does the patient have one of the following necessary risk factors?
a. have a family history of abdominal aortic aneurysm
b. is a man age 65-75 who has smoked at least 100 cigarettes in his lifetime
Please take note that there is no Medicare Part B deductible, but coinsurance applies.
CPT Codes
-
76706 – Ultrasound for abdominal aortic aneurysm (AAA) screening
Common ICD-10 CODES
-
???
© 2022 Texas Sonography Associates | Site by JQ