AAA ultrasounds

agott

Networker
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Our office is doing AAA Ultrasounds and were under the impression that we needed to bill Michigan Medicare for a G0389 for a screening code and using the screeing guidelines that they publish, BUT after further review it is looking like the only way we are able to bill for this code is if it is part of the welcome to medicare exam? Does anyone bill with this code and if you do how is it going and what is the criteria that you use. I am also thinking that if we can not use this code we could use the 93978-76770 or the 97979-76775 depending on the exam and if they meet that diagnosis requirments?
 

desiree384

Contributor
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To be eligible for this benefit, individuals must have taken advantage of the initial preventive physical examination, also known as the "Welcome to Medicare" visit. They also have not been previously provided an ultrasound screening under the Medicare program; and be included in at least one of the following risk categories:
-the beneficiary has a family history of abdominal aortic aneurysm
-the beneficiary is a man age 65 to 75 who has smoked at least 100 cigarettes in his lifetime.
Also it is only covered one time and there is no medicare part B deductible, but coinsurance applies.

When a claim is filed for an AAA screening test, the appropriate HCPCS code G0389 (76700, current CPT code) and one of the following ICD-9 codes must be reported:



o V15.82 -- Personal history of tobacco use presenting hazards to health.

o V17.4 -- Family history of other cardiovascular diseases.

o V81.2 -- Screening for other and unspecified cardiovascular conditions.

We do bill for these and we have been receiving payment so far.
 

lisammy

Guru
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Bowling Green, KY
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My question is "Are all of these ultrasounds being performed as screenings" or do some of your pt have known aneurysms and this is a yearly check up. We do annual checks for AAA pt in our office and I bill using a 93979 alone, no 70000 code is needed(inclusion notes at begining of 93000 series included supervision and interputation. We do not do Welcome to medicare screenings so I could not comment on that part.:)
 
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DBOYD

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My question is "Are all of these ultrasounds being performed as screenings" or do some of your pt have known aneurysms and this is a yearly check up. We do annual checks for AAA pt in our office and I bill using a 93979 alone, no 70000 code is needed(inclusion notes at begining of 93000 series included supervision and interputation. We do not do Welcome to medicare screenings so I could not comment on that part.:)
based on our CT-US Dept - the correct CPT for AAA U/S is 76775 Retroperitoneal -limited. which equals the requirements of G0389
 
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