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AAA Billing

Cathy Posted Thu 21st of April, 2011 13:43:22 PM

The 'G0389' is frequently used for Abdominal Aortic Aneurism Screening during the Welcome to Medicare period. However, do other carriers (or Medicare, when the IPPE period is past) generally reimburse for AAA Screening otherwise? What would normally be considered an acceptable medical necessity in order to screen for AAA? Would "screening" not be acceptable and only a study used as a "diagnostic" exam be appropriate?

SuperCoder Answered Thu 21st of April, 2011 18:41:25 PM

With all the other conditions for reimbursment of AAA screening compliant for reimbursemt, if we have billed with V70.0(screening code), then it would be appropriate. If faced with denials in such a situation, it might have been a computer glich. To handle it, we should refile on paper with medical records mentioning the details of the past visits to justify the timing of the AWV as appropriate for reimbursement.
On the other hand, if any abnormality of the abdominal aorta is found, it has been a practice of many to bill it with G0389 for better reimbursement.

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