ICD Code Diagnosis for Cardiac Rehabilitation

ICD Code Diagnosis for Cardiac Rehabilitation

Cardiac rehabilitation seemingly benefits patients with coronary heart disease and those with heart failure in terms of physical, mental, cognitive, and social function; and a reduction in morbidity, mortality, and healthcare costs
The following ICD-9 Diagnosis codes will allow payment for Cardiac Rehab Services.

Cardiac rehabilitation is a comprehensive intervention that includes the components of exercise training, education, psychosocial management, and a behavioral modification program designed to improve the physical and emotional conditions of patients with heart disease.

 

1. An acute myocardial infarction (MI – heart attack) within the preceding 12 months
 410.02 Acute myocardial infarction of anterolateral wall, subsequent episode of care
 410.12 Acute myocardial infarction of other anterior wall, subsequent episode of care
 410.22 Acute myocardial infarction of inferolateral wall, subsequent episode of care
 410.32 Acute myocardial infarction of inferoposterior wall, subsequent episode of care
 410.42 Acute myocardial infarction of other inferior wall, subsequent episode of care
 410.52 Acute myocardial infarction of other lateral wall, subsequent episode of care
 410.62 Acute myocardial infarction, true posterior wall infarction, subsequent episode of
care
 410.72 Acute myocardial infarction, subendocardial infarction, subsequent episode of care
 410.82 Acute myocardial infarction of other specified sites, subsequent episode of care
 410.92 Acute myocardial infarction of unspecified site, subsequent episode of care
 412 Old myocardial infarction

2. Coronary artery bypass graft surgery (CABG)
 414.02 Coronary atherosclerosis of autologous vein bypass graft
 414.03 Coronary atherosclerosis of nonautologous biological bypass graft
 414.04 Coronary atherosclerosis of artery bypass graft
 414.05 Coronary atherosclerosis of unspecified type of bypass graft
 414.06 Coronary atherosclerosis of native coronary artery of transplanted heart
 414.07 Coronary atherosclerosis of bypass graft (artery) (vein) of transplanted heart
 414.8 Other specified forms of chronic ischemic heart disease
 414.9 Chronic ischemic heart disease, unspecified.

3. Current stable angina pectoris
 413.0 angina decubitus
 413.1 prinzmetal angina
 413.9 Other and unspecified angina pectoris

4. Heart valve repair or replacement
 V42.2 Heart valve replaced by transplant
 V43.3 Heart valve replaced by other means, heart assist device
 V58.73 Aftercare following surgery of circulatory system (only to describe cardiac valvular
repair)

5. Percutaneous transluminal coronary angioplasty (PTCA) or coronary stenting
 V45.81 Postprocedural aortocoronary bypass status
 V45.82 Postprocedural percutaneous transluminal coronary angioplasty status

6. Heart or heart-lung transplantation
 V42.1 Heart replaced by transplant

 V43.89 Other organ or tissue replacement (use for heart/lung transplant)

7. Stable chronic heart failure
 428.22 Chronic systolic heart failure
 428.32 Chronic diastolic heart failure
 428.42 Chronic combined systolic and diastolic heart failure

The following ICD-10 CM Diagnosis codes will allow payment for dates of service on or after 10/1/2015:

1. An acute myocardial infarction (MI – heart attack) within the preceding 12 months
 I21.01 ST elevation (STEMI) myocardial infarction involving left main coronary artery
 I21.02 ST elevation (STEMI) myocardial infarction involving left anterior descending
coronary artery
 I21.09 ST elevation (STEMI) myocardial infarction involving other coronary artery of
anterior wall
 I21.11 ST elevation (STEMI) myocardial infarction involving right coronary artery
 I21.19 ST elevation (STEMI) myocardial infarction involving other coronary artery of
inferior wall
 I21.21 ST elevation (STEMI) myocardial infarction left circumflex coronary artery
 I21.29 ST elevation (STEMI) myocardial infarction involving other sites
 I21.3 ST elevation (STEMI) myocardial infarction of unspecified site
 I25.2 Old myocardial infarction

2. Coronary artery bypass graft surgery (CABG)
 I25.5 Ischemic cardiomyopathy
 I25.709 Atherosclerosis of coronary artery bypass graft(s), unspecified, with unspecified
angina pectoris
 I25.708 Atherosclerosis of coronary artery bypass graft(s), unspecified, with other forms of
angina pectoris
 I25.810 Atherosclerosis of coronary artery bypass graft(s) without angina pectoris
 I25.811 Atherosclerosis of native coronary artery of transplanted heart without angina
pectoris
 I25.812 Atherosclerosis of bypass graft of coronary artery of transplanted heart without
angina pectoris
 I25.89 Other forms of chronic ischemic heart disease
 I25.9 Chronic ischemic heart disease, unspecified

3. Current stable angina pectoris
 I20.1 Prinzmetal angina
 I20.8 Other forms of angina pectoris
 I20.9 Angina pectoris, unspecified

4. Heart valve repair or replacement
 Z95.1 Presence of aortocoronary bypass graft
 Z95.2 Presence of prosthetic heart valve (NOTE: not acceptable as a primary dx)
 Z95.3 Presence of xenogenic heart valve
 Z95.4 Presence of other heart-valve replacement

5. Percutaneous transluminal coronary angioplasty (PTCA) or coronary stenting
 Z95.5 Presence of coronary angioplasty implant and graft
 Z98.61 Coronary angioplasty status
6. Heart or heart-lung transplantation
 Z94.1 Heart transplant status
 Z94.3 Heart and lungs transplant status
7. Stable chronic heart failure
 I50.22 Chronic systolic (congestive) heart failure
 I50.32 Chronic diastolic (congestive) heart failure
 I50.42 Chronic combined systolic (congestive) and diastolic (congestive) heart failure

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