Medicare covers cardiac rehabilitation exercise programs for patients who meet the following criteria:
• Have a documented diagnosis of acute myocardial infarction within the preceding 12 months; or
• Have had coronory bypass surgery; or
• Have stable angina pectoris; or
• Have had heart valve repair/replacement; or
• Have had percutaneous transluminal coronary angioplasty (PTCA) or coronary stenting; or
• Have had a heart or heart-lung transplant.
Effective for dates of services on or after March 22, 2006, services provided in connection with a cardiac rehabilitation exercise program may be considered reasonable and necessary for up to 36 sessions. Patients generally receive 2 to 3 sessions per week for 12 to 18 weeks. The contractor has discretion to cover cardiac rehabilitation services beyond 18 weeks. Coverage must not exceed a total of 72 sessions for 36 weeks.
Cardiac rehabilitation programs shall be performed incident to physician’s services in outpatient hospitals, or outpatient settings such as clinics or offices. Follow the policies for services incident to the services of a physician as they apply in each setting.
Coding Requirements
The following are applicable HCPCS codes:
• 93797 - Physician services for outpatient cardiac rehabilitation; without continuous ECG monitoring (per session)
• 93798 - Physician services for outpatient cardiac rehabilitation; with continuous ECG monitoring (per session)
Learn Medical Billing Process, Tips to best AR Specialist. Medical Insurance Billing codes, Denial, procedure code and ICD 10, coverage guidelines. Demographic, charge, payment entry, AR process and eligibility and follow up. How to Guide.
Pages
- Home
- Medical Billing Question and Answer - Terms
- Insurance Denial Claim Appeal Guidelines.
- Medical Billing Downloads
- Understand Medical Billing
- Medical Billing Outsource
- Medicare Coverage and Plan Overview
- Advertise with us
- EVALUATION AND MANAGEMENT CPT code [99201-99499] - Full List
- Overall Medical billing process
- CPT Code 99201, 99202, 99203, 99204, 99205 - Which code to USE
- Internal Medical Billing Audit - how to do

Subscribe to:
Post Comments (Atom)
Medical Billing Popular Articles
-
NURSING SERVICES Nursing services are covered on an intermittent (separated intervals of time) basis when provided by, or under the direc...
-
Its often confused that BCBS have lot of prefixes and where to contact. However we have some guide to follow, using prefixes we could find t...
-
GENERAL INFORMATION This chapter applies to Home Health providers. Home health is a covered Medicaid benefit for beneficiaries whose co...
-
Medicare denial code and Descripiton 1 Deductible Amount 2 Coinsurance Amount 3 Co-payment Amount 4 The procedure code is inconsistent ...
-
Timely Filing Every insurance company has a time window in which you can submit claims. If you file them later than the allowed time, you ...
-
VISION SCREENING PCPs must perform a subjective vision screening (i.e., by history) at each well child visit. For asymptomatic children 3 ...
-
When an ERA is received, providers may: •Post decision and payment information automatically, for individual claims included in an R...
-
a. General Requirements When Medicare is the secondary payer, the claim must first be submitted to the primary insurer. The primary insure...
-
CPT code and description 80050 - General health panel This panel must include the following: Comprehensive metabolic panel (80053), ...
-
CPT CODE AND Description 99391 - Periodic comprehensive preventive medicine reevaluation and management of an individual including an age...

No comments:
Post a Comment