Medicare's coverage of ultrasound screening for Abdominal Aortic Aneurysm (AAA) is designated in section 5112 of the Deficit Reduction Act (DRA) of 2005 and effective for services furnished on or after January 1, 2007.  Payment may be made for a one-time ultrasound screening for AAA for eligible beneficiaries.

What the Beneficiary Should Know About Abdominal Aortic Aneurysm:

• Abdominal aortic aneurysm is a weakness in the wall of the major blood vessel that supplies blood to the lower part of the body.
• Pressure from the flowing blood can cause bulging or a balloon-like area to appear.
• The bulge/balloon can rupture, leading to serious internal bleeding.
• Some risk factors for AAA include a family history of AAA, a history of smoking, especially in men over 60 years of age, high blood pressure and evidence of atherosclerotic vascular disease.

Eligibility:

To be eligible for this benefit, individuals must:

• Have taken advantage of the initial preventive physical examination, also known as the "Welcome to Medicare" visit;
• Have not been previously provided an ultrasound screening under the Medicare program; and
• Be included in at least one of the following risk categories:
  • The beneficiary has a family history of Abdominal Aortic Aneurysm.
  • The beneficiary is a man age 65 to 75 who has smoked at least 100 cigarettes in his lifetime.
  • The beneficiary manifests other risk factors in a beneficiary category recommended for screening by the United States Preventive Services Task Force (USPSTF) regarding AAA, as specified by the Centers for Medicare & Medicaid Services (CMS) through the national coverage determination process.

Cost to the Beneficiary:

• There is no Medicare Part B deductible.
• A 20% coinsurance applies.

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Abdominal Aortic Aneurysm:  What You Should Know

Page Last Modified: 02/03/2009 9:29:31 AM
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