Outpatient Facility Coding Alert

Question: What criteria need to be met in order for a Medicare patient to qualify for an abdominal aortic aneurysm (AAA) ultrasound (US) screening?

New York Subscriber

Answer: You will report a screening US exam for AAA using code 76706 (Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA)). Medicare will cover this exam as long as the patient meets one of the following criteria:

• “Family history of AAA (male and female).
• “Male patient age 65 to 75 who has smoked at least 100 cigarettes in his lifetime.
• “Other risk factors that are described in a category recommended by the United States Preventive Services Task Force.”

Note that Medicare will only pay for one screening exam per lifetime when one of the above criteria is met. Unless your Medicare contractor states otherwise, report this service using diagnosis code Z13.6 (Encounter for screening for cardiovascular disorders).  

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