Oct 01, 2015 · Effective January 1, 2022, Cardiac Rehabilitation (CR) codes 93797 and 93798 have been assigned as category 3 codes on the Physician Fee Schedule List of Telehealth Services CY 2022 and will allow these services via telehealth until December 31, 2023. Public Health Emergency Telehealth Services
Oct 12, 2017 · Per IOM 100-02, Chapter 15, Section 232, “Cardiac rehabilitation (CR) services mean a physician-supervised program that furnishes physician prescribed exercise, cardiac risk factor modification, including education, counseling, and behavioral intervention; psychosocial assessment, outcomes assessment, and other items/services as determined by ...
Outpatient Cardiac Rehabilitation Use Surveillance. Methodology. 3 | Page Table 1. Diagnosis and Procedural Codes* Used to Identify Cardiac Rehabilitation-qualifying Events . Main Surveillance . Acute Myocardial Infarction ICD-9-CM Diagnosis Codes ICD-10-CM Diagnosis Codes 410.00, 410.01, 410.02, 410.10, 410.11, 410.12, 410.20, 410.21, 410.22, 410.30,
ICD-9 Code ICD-9 Description ICD-10 Code ICD-10 Description 410.11 Acute myocardial infarction of other anterior wall, initial episode of care I22.0 Subsequent ST elevation (STEMI) myocardial infarction of anterior wall 410.21 Acute myocardial infarction of inferolateral wall, initial episode of care I21.19
CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.
Title XVIII of the Social Security Act, Section 1833 (e) states that no payment shall be made to any provider of services or other person under this part unless there has been furnished such information as may be necessary in order to determine the amounts due such provider or other person under this part for the period with respect to which the amounts are being paid or for any prior period..
History/Background and/or General Information:#N#It has come to Novitas’ attention that providers who are not physicians (MD or DO) are prescribing (i.e.
Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type.
Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination.
Cardiac Rehabilitation (CR) means a comprehensive, physician-supervised program that furnishes physician-prescribed exercise, cardiac risk factor modification, psychosocial assessment, and outcomes assessment. Thepurpose of the program is to restore individual patients with certain cardiac conditions to active and productivelives as demonstrated in the outcomes assessment.
The medical director inconsultation with staff is involved in directing the progress of individuals in the program. This individualmust possess all of the following (1) expertize in the management of individuals with cardiacpathophysiology; (2) cardiopulmonary training in basic life support or advanced cardiac life support; and
◦ Evaluation and Management (E/M) services, Electrocardiograms (ECGs) and other diagnosticservices may be covered on the day of CR if these services are separate and distinct from the CRprogram and are reasonable and necessary, but would not be covered if provided routinely as partof the CR program.
The facility meets the definition of a hospital outpatient department or a physician-directed clinic, i.e., a physician is on the premises available to perform medical duties at all times the facility is open and each patient is under the care of a hospital or clinic physician.
Evaluation and Management (E/M) services, ECGs and other diagnostic services may be covered on the day of cardiac rehabilitation if these services are separate and distinct from the cardiac rehabilitation program and are medically necessary.
People of all ages with heart conditions can benefit from a cardiac rehab program.
Medicare and most other insurers provide reimbursement for cardiac rehab undertaken after most of the conditions outlined above.