Wiki 76706 Screening AAA for patient over 75

[coffee2day]

Hi any advice for CPT 76706 if done on a patient over 75? The medicare guidelines state they cover this screening for male age 65-75 who has smoked.

From the report below, is 76706 the only option? This seems not to be a screening because the patient has a known infrarenal aaa. Could CPT 93978 be used, duplex scan of aorta, ivc, iliac complete?

HISTORY: Follow-up infrarenal abdominal aortic aneurysm, comparison CT scan last year.TECHNIQUE:
Multiple transverse and longitudinal images of the retroperitoneum, abdominal
aorta, and common iliac arteries
*
FINDINGS:
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Abdominal Aorta: Continued infra renal aneurysm
Maximal AP diameter: 3.2 cm.
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Common iliac arteries: No aneurysmal dilatation.
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SITE: AP diameter (cm)
**
Suprarenal Aorta 2.1
**
Pararenal Aorta 2.0
**
Infrarenal Aorta 3.2
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Right Common Iliac 1.2
**
Left Common Iliac 1.0
*
*
**
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CONCLUSIONS: Infrarenal aneurysm measuring 3.2 cm. No common iliac artery
aneurysm noted bilaterally
*

 

[AmandaBriggs]

I recommend using either 93978 for a full Aortic Duplex study or 93979 for a limited Aortic Duplex study. The AAA screening code, 76706, is a once in a lifetime preventive benefit to Medicare beneficiaries that meet very specific criteria. As this is a screening service, the code does not cover studies for beneficiaries with a known AAA aneurysm. Here is a link to the MLN Matters article that discusses this in detail: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM5235.pdf

 

[cubbiecatz]

76775 is a limited retroperitoneum which covers the abdominal aorta. This is what I use when the AAA is already known.

 

[Michael0630]

Good afternoon,

Would CPT 76775 be valid for this? The patient had 76706 done in 2022-

HISTORY: Follow-up abdominal aortic aneurysm.

COMPARISON: Ultrasound dated 11/30/2022.

TECHNIQUE: Ultrasound of the abdominal aorta was performed with Doppler supplementation.

FINDINGS:

The proximal abdominal aorta measures 2.4 cm, and the midportion 2.5 cm. The patient is status post endograft repair of a distal abdominal aortic aneurysm. The aneurysm sac measures 3.5 cm diameter, unchanged. There appears to be blood flow within the aneurysm sac, detected by spectral and color Doppler. The endograft is patent, with normal blood flow. The common iliac arteries appear normal. No periaortic collection is visualized.

IMPRESSION:

Stable size of the aneurysm sac status post endograft repair. Possible endoleak. CT angiogram could be performed for further evaluation.

 

[xXxPARAGONxXx]

Good afternoon,

Would CPT 76775 be valid for this? The patient had 76706 done in 2022-

HISTORY: Follow-up abdominal aortic aneurysm.

COMPARISON: Ultrasound dated 11/30/2022.

TECHNIQUE: Ultrasound of the abdominal aorta was performed with Doppler supplementation.

FINDINGS:

The proximal abdominal aorta measures 2.4 cm, and the midportion 2.5 cm. The patient is status post endograft repair of a distal abdominal aortic aneurysm. The aneurysm sac measures 3.5 cm diameter, unchanged. There appears to be blood flow within the aneurysm sac, detected by spectral and color Doppler. The endograft is patent, with normal blood flow. The common iliac arteries appear normal. No periaortic collection is visualized.

IMPRESSION:

Stable size of the aneurysm sac status post endograft repair. Possible endoleak. CT angiogram could be performed for further evaluation.

Yes, and I would only code 76775. I would not code any CPT code for a duplex scan (e.g., 93978), as it does not appear that there is adequate documentation to justify coding it.

Instead, it appears that the spectral/Doppler was only used for a quick look to check whether flow is present [in the aneursym sac].[1]

References

[1] https://www.acr.org/Advocacy-and-Ec...Radiology-Coding-Source-January-February-2007