US · guidance
CMS Pub. 100-04, ch. 18, § 100.2
A/B MAC (B) Billing Requirements
Effective for dates of service, January 1, 2005, and later, A/B MACs (B) shall recognize the above HCPCS codes for
Cardiovascular Disease Screening.
A/B MACs (B) shall pay for Cardiovascular Disease Screening once every 60 months.
A claim that is submitted for Cardiovascular Disease Screening shall be submitted in the following manner:
The line item shall contain 80061, 82465, 83718 or 84478 with one of the following diagnoses:
If ICD-9-CM is applicable
V81.0 - Special screening for ischemic heart disease,
V81.1 - Special screening for hypertension or
V81.2 - Special screening for other and unspecified cardiovascular conditions
If ICD-10-CM is applicable
Z13.6 - encounter for screening for cardiovascular disease
The appropriate diagnosis codes are reported in the header and pointed to the line item.
History
(Rev. 3329, Issued: 08-14-15, Effective: 01-01-12, Implementation: 09-14-15)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
1c84169b900472698b9adbf5a0593ab9caf870faf4e1b419a929ebb9cbe764c2
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