November 2006 | Vol. 24, No. 11

AAA Screening Provision Included in Deficit Reduction Act

As you may recall, last year SVU supported the Screening Abdominal Aortic Aneurysms Very Efficiently (SAAAVE) Act before Congress. While the SAAAVE Act was not passed itself, the AAA Screening provision of the SAAAVE Act was included in the DRA legislation passed by Congress at the end of last year and signed by the President in February 2006.

Section 5112 of the DRA of 2005 amended section 1861 of the Social Security Act to provide for coverage under Medicare Part B of ultrasound screening for AAAs. Beginning Jan. 1, 2007, CMS is proposing to pay for ultrasound screening for AAAs through the use of a new HCPCS code GXXXX (Ultrasound, B-scan and/or real time with image documentation; for abdominal aortic aneurysm (AAA screening). CMS is proposing that payment for this service be made at the same level as CPT Code 76775 (Ultrasound, retroperitoneal (e.g., renal, aorta, nodes), B-scan and/or real time with image documentation; limited). CPT code 76775 is used to bill for the service when it is provided as a diagnostic test.

At this point it appears this benefit will only be available as part of a new Medicare Beneficiary “Welcome to Medicare” physical exam. Additional information will likely become available following release of the CMS Final Rule on the DRA sometime in November. Following that, SVU recommends that you contact your local Medicare carrier for additional specific information.