Procedure Code(s) and Description
76705 Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up)
76706 Ultrasound Screening Study for Abdominal Aortic Aneurysm
Preventive Benefit Instructions
Age 65 through 75 (ends on 76thbirthday). Requires at least one of the diagnosis codes listed in this row
Diagnosis Code(s)- covered ICD 10 codes
F17.210, F17.211, F17.213, F17.218, F17.219, Z87.891
Medicare guidelines for using AAA screen
Effective for services furnished on or after January 1, 2017, the following code and modifiers, are used for AAA screening services:76706: Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA). (For screening ultrasound or duplex ultrasound of the abdominal aorta other than screening, see 76770, 76775, 93978, 93979.)
Short Descriptor: Us abdl aorta screen AAA
Modifiers: TC, 26
Fee amount for technical and professional component
CPT 76705
Professional $30.24
Technical $63.72
Global$93.96
CPT 76706
Professional $28.44
Technical$68.40
Global$96.84
Documentation Requirements
Ultrasound performed using either a compact portable ultrasound or a console ultrasound system are reported using the same CPT codes as long as the studies that were performed meet all the following requirements:
• Medical necessity as determined by the payer
• Completeness
• Documented in the patient’s medical record
A separate written record of the diagnostic ultrasound or ultrasound-guided procedure must be completed and maintained in the patient record.7 This should include a description of the structures or organs examined and the findings and reason for the ultrasound procedure(s). Diagnostic ultrasound procedures require the production and retention of image documentation. It is recommended that permanent ultrasound images, either electronic or hardcopy, from all ultrasound services be retained in the patient record or other appropriate archive.
Coverage
Use of ultrasound-guided procedures may be a covered benefit if such usage meets all requirements established by the particular payer. In many cases, because the use of ultrasound guidance is an emerging technology, it may be considered investigational and may not be a covered procedure.It is advisable that you check with your local Medicare Contractor. Also, it is essential that each claim be coded appropriately and supported with adequate documentation in the medical record.
Coverage by private payers varies by payer and by plan with respect to which medical specialties may perform ultrasound services. Some payers will reimburse ultrasound procedures to all specialties while other plans will limit reimbursement for ultrasound procedures to specific types of medical specialties.
In addition, there are plans that require providers to submit applications requesting these services be added to the list of services performed in their practice. It is important that you contact the payer prior to submitting claims to determine their requirements
