Wiki DX sequence Cardiac Rehab

[sondra hayden]

I have been working on a reimbursement issue for cardiac rehab that I believe may pertain to the sequencing of the diagnoses codes. I think, based on the 2012 ICD-9 codebook, that the V45.81 for post-CABG should be the secondary diagnosis and the condition, i.e. 414.00, 414.01, etc. should be primary. The note at the bottom of the page in the 2012 codebook is that V45.81 is not acceptable as a primary diagnosis. We are concerned that out 3M Encoder does not edit for the sequence on this.

Would any of you familiar with coding & billing of Cardiac Rehab let me know what you have found is recommended when submitting diagnoses to CMS?

Thanks for your help. I am located in the J-14 MAC territory.