December 2006 | Vol. 24, No. 12

HCPC Code G0389 for AAA Screening Provision

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. It goes into effect on 1/01/2007.

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. CMS has assigned HCPCS code G0389 (Ultrasound, B-scan and/or real time with image documentation; for abdominal aortic aneurysm (AAA screening) to be reported on or after January 1, 2007, to describe an ultrasound screening test for AAA. Payment for G0389 will be made at the same level as CPT Code 76775 (Ultrasound, retroperitonal [e.g., renal aorta modes], B-scan and/or renal time with image documentation; limited), which is assigned to APC 0266 (Level II Diagnostic and Screening Ultrasound). The payment rate for APC 0266 is $95.93 for CY 2007.

This benefit will only be available as part of a new Medicare Beneficiary "Welcome to Medicare" physical exam. Additional information on the payment rate is available on the Code-by-Code Impact of DRA Caps on Vascular Ultrasound Payments chart on the SVU website home page. SVU recommends you contact your local Medicare carrier for any additional questions you may have on the AAA Screening study provision.