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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