New ICD-10 Code Added for Ultrasound AAA Screening

CMS released Transmittal 13694 to add ICD 10 CM code Z13.6, Encounter for screening for cardiovascular disorders, as a covered diagnosis code for Abdominal Aortic Aneurysm (AAA) screening (CPT code 76706) for Medicare claims. This addition ensures claims submissions align with the updated Medicare Learning Network^® (MLN) preventative services guidance.

When billing Medicare for AAA screening, providers must report Z13.6 in combination with either a personal history of nicotine dependence (Z87.891), current nicotine dependence (F17.210–F17.219), or family history of other specified conditions (Z84.89). These combinations reflect Medicare coverage criteria for beneficiaries at elevated risk, such as those with a smoking history or a relevant family history.

In addition, CMS recently released Transmittal 13760, which contains coding revisions to various National Coverage Determinations (NCD) relevant to radiology.

Modifications include the following NCDs:

• NCD 150.13 Percutaneous Image-Guided Lumbar Decompression (PILD) for Lumbar Spinal Stenosis: Contractors shall end date CPT code 0275T effective Dec. 31, 2025, and add CPT code 62330 effective Jan. 1, 2026. Also, Contractors shall add Part B POS code 19 effective Jan. 1, 2016.
• NCD 160.18 Vagus Nerve Stimulation (VNS): Contractors shall note that NCD 160.18 is specific to Vagus Nerve Stimulation (VNS) for medically refractory partial onset seizures for whom surgery is not recommended or for whom surgery has failed and treatment-resistant depression, it is unrelated to obstructive sleep apnea. The ICD-10 diagnosis code G47.33 for obstructive sleep apnea is being removed from the covered indications for NCD 160.18 under CPT 64568. Contractors shall update any previous system logic with this CPT and diagnosis code combination accordingly effective Jan. 1, 2025. Coverage determinations for non-VNS indications remain at MAC discretion. In addition, Part A MACs should suspend FISS RCs 59039 and 59040 at MAC discretion to allow coverage of diagnosis codes that have an indication outside of NCD 160.18.
• NCD 220.6.17 Positron Emission Tomography (PET) (FDG) for Oncologic Conditions: Effective Oct. 1, 2018, Contractors shall add ICD-10 Dx code R93.89.

See Transmittal 13760 for further details, including a full list of affected NCDs.

For more information, contact Stacy Shaw, ACR Economic Policy Analyst.