Corporate Compliance

Note: Cardiac Rehab and Intensive Cardiac Rehab revisited

Medicare Insider, June 1, 2010

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Editor’s note: Debbie Mackaman, RHIA, CHCO, regulatory specialist for HCPro, Inc., is the author of this week’s note from the instructor.

It’s official – summer has finally arrived! Well, at least according to the holiday weekend that just passed and I hope you all enjoyed the time away.Last week CMS published several transmittals (R126BP, R1974CP, R339PI, and R170FM) and MLN Matters articles that finally clarify how these two programs must operate to meet coverage for payment. Let’s take a look at the similarities and differences of each program.

Effective January 1, 2010, Medicare Part B covers cardiac rehabilitation (CR) and intensive cardiac rehabilitation (ICR) services provided in a physician’s office or a hospital outpatient setting for patients who have one or more of the following diagnoses:

  • An acute myocardial infarction within the preceding 12 months;
  • A coronary artery bypass surgery (CABG)
  • Current stable angina pectoris
  • Heart valve repair or replacement
  • Percutaneous transluminal coronary angioplasty (PTCA) or coronary stenting
  • A heart or heart-lung transplant
  • Other cardiac conditions specified through a national coverage determination (NCD)

Continue reading Debbie Mackaman's note.



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