Primary Care Coding Alert

READER QUESTIONS:

How to Justify AAA Screenings

Question: Does anyone know the correct ICD-9 code for a screening duplex for an abdominal aortic aneurysm? It is supposed to be covered as a screening test for males on Medicare and is recommended by the US Preventive Services Task Force. I got a call back from the local hospital that I need to give them an ICD-9 code for an actual aneurysm, which I can not do because it is not true, so the test never gets done. Tennessee Subscriber Answer: There is no ICD-9 code specific to screening for abdominal aortic aneurysm (AAA). However, you can keep future claims clean by following the rules available at Medicare's Web site: www.cms.hhs.gov/transmittals/downloads/R1113CP.pdf. For example, for Medicare to cover the code, the patient must meet one of the following risk categories: • Has a family history of AAA • Is a man age 65 to 75 who has smoked at [...]
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