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Checklist: Endovascular cardiac valve replacement and supplement procedures

This checklist is intended to provide health care providers with a reference for use when responding to additional documentation requests for endovascular cardiac valve replacement and supplement procedure (DRG 266 and 267).

Part B service-specific review -- outpatient rehabilitation services (CPT code 97110)

View this summary for outpatient rehabilitation services (August - November 2020 and August 2021).

Part A service-specific review - hyperbaric oxygen therapy (G0277)

View this summary for outpatient rehabilitation services (December 2020).

Part A service-specific review - (CPT 97530 therapeutic activities)

View this summary for outpatient rehabilitation services (January through August 2021).

Part A service-specific review -- (CPT 97110 therapeutic activities)

View this summary for outpatient rehabilitation services (August - November 2020).

Part B service-specific review – psychotherapy services (CPT codes 90832-90839)

View this summary for psychotherapy services (December 2020 - March 2021).

Targeted probe and educate (TPE)

TPE is one process that a MAC can utilize when providers are selected by medical review.

Targeted probe and educate (TPE) round results: Inpatient rehabilitation facilities (IRF)

Review the targeted probe and educate (TPE) round results for inpatient rehabilitation facility (IRF).

Post-payment service-specific reviews

Medical review of claims helps to ensure that Medicare pays for services that are covered, correctly coded, and medically reasonable and necessary.