Abdominal aortic aneurysm (AAA) is a ballooning of the aorta, the largest blood vessel in the human body, which extends into the abdomen.  If the wall of this blood vessel becomes weakened, it can stretch, "balloon" out and rupture.  A rupture, if left untreated, can lead to life-threatening internal bleeding.  Ruptured AAAs are the 10th leading cause of death in men over age 50 in the United States, resulting in over 15,000 deaths annually.  The exact cause of this condition is unknown.  However, it often occurs in older adults, especially males, those with a high cholesterol level, and in smokers.  There also tends to be a genetic link to this disorder.

Many cases of ruptured AAA can be prevented with early diagnosis and medical treatment.  This condition usually does not cause symptoms, but an abdominal ultrasound can accurately detect and determine the size of aneurysms about 98% of the time.  Patients who have been treated before a rupture takes place usually do better than those treated as an emergency after rupture.  Patients who have larger aneurysms, hypertension, or lung diseases tend to be at greater risk for rupture.  Larger aneurysms are usually removed with surgery.  In smaller aneurysms, with a less invasive procedure, a stent/graft can be placed within the aorta which strengthens the vessel wall and can prevent a future rupture.  A healthy diet low in fat can reduce plaques that can lead to AAA and prevent an aneurysm from growing.  Smoking should be avoided.

What Medicare covers:

As of January 1, 2007, Medicare will pay for a one-time ultrasound screening for AAA for beneficiaries who are at risk.  Patients considered to be at risk include:

• Those with a family history of AAA
• Men age 65 to 75 who have smoked at least 100 cigarettes in their lifetime

Eligible beneficiaries must receive a referral for the screening as a result of their Welcome to Medicare physical exam which is only available in the first 6 months of Medicare eligibility.

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Related Links Inside CMS
MLN Matters Article-Coverage of Ultrasound Screening for AAA [.pdf, 35.2KB] MLN Matters Article-Implementation of One-Time-Only Ultrasound Screening for Adominal Aortic Aneurysms [.pdf, 93.3KB]
Related Links Outside CMS
Society of Thoracic Surgeons- Patient Information: Abdominal Aortic Aneurysm

Page Last Modified: 02/03/2009 9:32:25 AM
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