Cardiology Coding Alert
G0389 Referral Opportunities Got Wider
Question: One of my coworkers said the AAA screening no longer has to be ordered during the Welcome to Medicare visit. Is that true?
Utah Subscriber
Answer: Yes, Medicare eliminated the one year time limit for referral of the abdominal aortic aneurysm (AAA) screening. That means Medicare will cover the AAA screening even if the patient doesn’t get the referral as part of the Initial Preventive Physical Examination (IPPE), also known as the Welcome to Medicare Preventive Visit (WTM). The implementation date, when payers had to be prepared for the change, was Nov. 18, 2014. But the change is effective for dates of service on or after Jan. 27, 2014.
The patient does still need a referral, though, and needs to meet the other longstanding requirements for eligibility, such as falling into specified risk categories. To review those requirements, see pp. 16-17 of the transmittal at www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R3096CP.pdf.
To report the screening, continue to use G0389 (Ultrasound B-scan and/or real time with image documentation; for abdominal aortic aneurysm [AAA] screening).
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