Checklist: Cardiac rehabilitation services
This checklist is being provided as a tool to assist providers when responding to medical record documentation requests for cardiac rehabilitation services.
It is the responsibility of the practitioner who provided the services to ensure the correct submission of documentation.
| Check | Documentation description |
|---|---|
| Documentation is for the correct beneficiary. | |
| Documentation contains a valid and legible signature. | |
| Documentation is for the correct date of service. | |
|
Documentation includes evidence that the beneficiary experienced one or more of the following criteria:
|
|
|
Documentation indicating the cardiac rehabilitation program includes the following components:
|
|
| Documentation includes evidence of total time spent in sessions on the selected date of service for review. | |
| If applicable and required, submitted documentation should include a beneficiary waiver of liability. |
Disclaimer
This checklist was created as an aid to assist providers. This aid is not intended as a replacement for the documentation requirements published in national or local coverage determinations, or the CMS documentation guidelines. It is the responsibility of the provider of services to ensure the correct, complete, and thorough submission of documentation.