Abdominal Aortic Aneurysm Screening (CPB 0702, reviewed 2025-12-19)

By 2025-12-19: Billing team must update claim edits in billing software to deny or route for review any AAA screening claims (CPT 76706) where patient is NOT a male aged 65+. Add payer-specific edit rules for Aetna to require ICD-10 code Z13.6 (screening for cardiovascular disorder) with patient age and sex verification. Reject all claims containing experimental codes (CCR2 PET/CT, m6A methylation analysis, JAK2 screening modalities, and AI-based screening/sizing) with explanation of non-coverage. Notify providers in writing that AAA screening coverage is limited to the specified population only; screening in women, men under 65, and men 65+ who have never smoked is non-covered. Update encounter forms and documentation templates to capture smoking history (F17.210-F17.219) to support medical necessity. Training: Educate billing staff and front desk on eligibility restrictions to prevent claim submission errors. Failure to implement edits will result in claim denials and potential recoupment from the practice.