Aorta is one of the main organs of abdominal region. It is the main artery from where all the small arteries arise. Arteries arising from the Aorta form Vascular Families. Vascular Families help us in Selective and Non-Selective catheterization coding. Ultrasound Procedure coding is very straight in radiology. We have already learned how to code abdominal ultrasound complete and limited in my previous post. But, in this article we will learn how to code single organ ultrasound separately with different payers. We will learn how to code Screening Abdominal Aortic Aneurysm (AAA) CPT code in brief in this article

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CPT code for abdominal aortic ultrasound for Commercial payers

As we know we use normal numerical codes for commercial payers. Here, also for ultrasound Aorta we are using normal codes only. But, Aorta being a part of abdomen many coders get confuse how to code it. As per the coding guidelines, even Aorta, being major part of abdomen, should be coded as Ultrasound limited of retroperitoneal region (76775). Many coder tend to code Ultrasound Aorta as 76705, considered as a part of Abdominal region. But, we should not follow this and it should always be coded as 76775 .i.e. Ultrasound Retroperitoneal Limited. This code is coded almost all commercial payers except Medicare.

76775– Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited

Use of CPT code 76706

Effective January 1, 2017, HCPCS code G0389 is being replaced by CPT code 76706.

76706 ; Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA)

This code was established in support of the recommendation of the United States Preventive Services Task Force (USPSTF) for screening ultrasound evaluation of the aorta. Per the ultrasound guidelines, code 76706 includes interpretation and report of the results of the screening. Do not report code 76706 for performance of screening that does not include clinician interpretation and creation of a report. This article discusses the USPSTF abdominal aortic ultrasound screening recommendations and other codes for aortic ultrasound.

An abdominal aortic aneurysm is a weakening in the wall of the infrarenal aorta that results in a bulge in this part of the aorta, typically with an anteroposterior diameter of 3 cm or greater in the adult population. AAAs often go undiagnosed because a large proportion of patients are asymptomatic until the aortic aneurysm ruptures, which is generally acute and often fatal. Most individuals who experience AAA rupture do not survive, with a mortality rate estimated near 90%. The risk of rupture is proportional to aneurysm size. Larger aneurysms are more likely to rupture than smaller aneurysms.

Screening is recommended to detect aneurysms early and to implement timely risk modification strategies. The USPSTF recommends that clinicians selectively offer screening with ultrasonography for AAA in males aged 65 to 75 years who have smoked. The Centers for Medicare & Medicaid Services allows screening of males age 65 to 75 who have smoked at least 100 cigarettes in their lifetime, but also allows assessment of any Part B beneficiary who has a family history of abdominal aortic aneurysms. Prior to January 1, 2017, a screening study for AAA was reported with HCPCS code G0389, Ultrasound B-scan and/or real time with image documentation; for abdominal aortic aneurysm (AAA) screening.

Clinical Example (CPT 76706)

A 65-year-old obese male smoker undergoes a screening duplex scan for abdominal aortic aneurysm.

Description of Procedure (CPT 76706)

The technologist who performs the examination is supervised. The ultrasound examination is interpreted, with evaluation of the target structures, and the measured aortic diameter is confirmed

ICD codes for Ultrasound Abdominal Aortic Aneurysm (AAA)

For ICD 10 codes Screening for Abdominal Aortic Aneurysm(AAA) is coded with Z13.6, Encounter for screening for cardiovascular disorders and abdominal aortic aneurysm as I71.4

When their is no confirm diagnosis for screening exam of AAA,

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