Cardiology
This page is a central location for cardiology information, including CMS resources.
Spotlight
- In May 2026, the U.S. Department of Health and Human Services Office of Inspector General (HHS/OIG) issued a report titled "Utilization Trends and Medicare Part B Billing for Office-Based Peripheral Vascular Procedures Raise Questions About Program Integrity". This data snapshot describes utilization trends for these procedures and flags billing patterns that warrant further scrutiny.
- Cardiac and Pulmonary Rehabilitation Programs
Enrolling
The following resources support enrollment activities for cardiology:
Policy Information
Not all services have a policy associated with them. We will consider Reasonable and Necessary Guidelines in the absence of a LCD, billing and coding article, NCD, or CMS manual instruction that limits coverage.
LCDs
Learn more about the LCD development process through the following:
Search for cardiology-related LCDs using these available resources:
- LCD Interactive Index Tool
- View First Coast's active / proposed LCDs on CMS Medicare Coverage Database (MCD)
NCDs
Search for cardiology-related NCDs using these available tools:
Medical Documentation
For a claim to be valid, documentation must demonstrate compliance with all applicable coverage, coding and billing requirements and substantiate the level of care billed. The following resources are specific to cardiology, but may not address all required medical documentation requirements:
- Medical Documentation Checklists
- MLN Matters Article MM14311, Cardiac Contractility Modulation for Heart Failure
Claim Submission and Reimbursement
- Anatomical Modifiers
- MLN Fact Sheet MLN909368, Cardiac Device Credits: Medicare Billing
- Coverage with Evidence Development
Additional Information
View our FastTrack to Medicare Coverage Policies Tool to locate guidelines
CMS
- CMS IOM Pub. 100-04 Medicare Claims Processing Manual, Chapter 12
- CMS IOM Pub. 100-04 Medicare Claims Processing Manual, Chapter 32, Section 140.2
- Physician Information Center
- Transcatheter Aortic Valve Replacement (TAVR) for Aortic Regurgitation (AR)
Education
View our wide selection of free, live and on-demand training options:
- View our upcoming Education Events Calendar
- View On-Demand Learning
Stay Informed
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