AAA screening

March 2nd, 2009 - Codapedia Editor
Categories:   Coding   Specialty Coding   Preventive Medicine Service  
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Medicare allows screening for Abdominal Aortic Aneurysm in very limited situations.

The screening must be ordered as part of the patient's Welcome to Medicare visit (Initial Preventive Physical Exam). That limits the screening to newly enrolled Medicare patients.  If the patient has not had the IPPE billed, then the screening service is not covered.

To bill for this screening, when appropriately ordered after an IPPE, use code G0389 and diagnosis code V81.2.  If you are  not sure if the patient had the IPPE, you must have the patient sign an Advance Beneficiary Notice (ABN) in order to hold the patient fiancially liable.

The IPPE is a once per lifetime benefit.  See the Codapedia article about this topic.  Also, teh patient must have one of these risk factors in order to be eligible for the service:
 
Ø      The beneficiary has a family history of abdominal aortic aneurysm
Ø      The beneficiary is a man age 65 to 75 who has smoked at least 100 cigarettes in his lifetime
Ø      The beneficiary manifests other risk factors in a beneficiary category recommended for screening by the United States Preventive Services Task Force (USPSTF) regarding AAA, as specified by the Secretary of Health and Human Services through the national coverage determination process.

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