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Independence Blue CrossMedicare Advantage · Billing Codes · Medical Policy · Cardiology, Internal Medicine, General PracticeHigh impact

MA10.002h, Cardiac Rehabilitation (CR) and Intensive Cardiac Rehabilitation (ICR) Programs

Effective date
Oct 1, 2026
Identified
Oct 2, 2026

Summary

Independence Blue Cross updated ICD-10 diagnosis codes for cardiac rehabilitation coverage effective 10/01/2026. Six cardiomyopathy codes were replaced with more specific granular codes (I42.0 and I42.8 terminated; I42.00, I42.01, I42.09, I42.81, and I42.89 added). Billing teams must update systems to use only the new codes to avoid claim denials.

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What to do

Action · 6 steps
01By 09/30/2026: Billing team must update billing software and claims system to remove outdated ICD-10 codes I42.0 and I42.8 from the cardiac rehabilitation policy (MA10.002h Attachment A).
02Add the five new ICD-10 codes (I42.00, I42.01, I42.09, I42.81, I42.89) to the approved diagnosis code list.
03Configure system validations to reject claims using old codes for cardiac rehabilitation services (CPT 93797, 93798, G0422, G0423, S9472) on or after 10/01/2026.
04Communicate to providers and coding staff the code changes and train them on correct code selection based on cardiomyopathy type documentation.
05Update internal coding guidelines and encounter forms.
06Claims submitted with terminated codes after the effective date will be denied.

Codes mentioned

9379793798G0422G0423S9472I42.0I42.8I42.00I42.01I42.09I42.81I42.89

Original notice

MA10.002h, Cardiac Rehabilitation (CR) and Intensive Cardiac Rehabilitation (ICR) Programs
medpolicy.ibx.com · Always check the source before changing claims.
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Related policy hubs

Independence Blue Cross policiesCardiologyInternal MedicineGeneral PracticeCode 93797Code 93798Code G0422Code G0423Code S9472Code I42.0Code I42.8Code I42.00Code I42.01Code I42.09Code I42.81Code I42.89

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