Name of the Procedure:

Common Name(s): Intensive Cardiac Rehabilitation (ICR)
Technical/Medical Terms: Intensive Cardiac Rehabilitation without continuous ECG monitoring and without exercise, per session (HCPCS Code G0423)

Summary

Intensive Cardiac Rehabilitation (ICR) is a structured program designed to help patients recover and improve their heart health after a cardiac event. This specific procedure (G0423) involves rehabilitation sessions that do not include exercise or continuous ECG monitoring. The program typically consists of personalized education and counseling to guide lifestyle changes, such as diet modifications and stress management techniques.

Purpose

Medical Conditions or Problems Addressed:

• Coronary artery disease
• Post-heart attack recovery
• Post-coronary artery bypass graft (CABG) surgery recovery
• Chronic heart failure
• Stable angina

Goals or Expected Outcomes:

• Improve heart health and overall fitness
• Educate patients on heart-healthy living
• Reduce the risk of future cardiac events
• Assistance in managing weight, blood pressure, cholesterol, and diabetes

Indications

Specific Symptoms or Conditions:

• Recent heart attack
• Post-surgical recovery from CABG or other cardiac surgery
• Diagnosed coronary artery disease
• Chronic heart failure management
• Stable chest pain (angina)

Patient Criteria:

• Patients recovering from a recent cardiac event or those with chronic symptoms
• Those unable to participate in physical exercise due to medical limitations

Preparation

Pre-procedure Instructions:

• No specific fasting or dietary restrictions
• Continue current medications unless otherwise directed by a healthcare provider
• Ensure all recent medical records and diagnostic test results are available for review

Diagnostic Tests or Assessments Required:

• Recent comprehensive cardiac evaluation
• Blood tests to assess cholesterol and glucose levels
• Blood pressure reading
• Review of medical history and medication list

Procedure Description

Step-by-Step Process:

1. Initial Assessment:
   • Medical history review and physical examination
   • Assessment of patient's specific needs, goals, and limitations
2. Educational Sessions:
   • One-on-one or group sessions focusing on lifestyle changes, diet, and stress management
   • Use of educational materials and interactive tools
3. Counseling:
   • Psychological and emotional support
   • Techniques for managing stress and anxiety

Tools, Equipment, or Technology Used:

• Educational materials (brochures, videos)
• Counseling space (private rooms or group settings)

Anesthesia or Sedation:

• Not applicable

Duration

• Each session typically lasts 1 to 1.5 hours.
• The program may span several weeks to months, with multiple sessions per week.

Setting

• Conducted in outpatient clinics, specialized rehabilitation centers, or hospital settings.

Personnel

• Cardiologists
• Cardiac rehabilitation specialists
• Nurses specializing in cardiac care
• Dietitians
• Psychologists or counselors

Risks and Complications

Common Risks:

• Minimal risks associated due to the non-physical nature of the sessions

Rare Risks:

• Psychological stress during counseling sessions
• Information overload if not paced according to patient comfort

Management of Complications:

• Regular monitoring and support from healthcare professionals
• Adjustments to the rehabilitation plan to fit patient comfort levels

Benefits

• Improved understanding of heart health and risk factors
• Positive lifestyle changes leading to better heart function
• Reduced risk of future cardiac events
• Psychological support and improved mental health

Onset of Benefits:

• Patients may start noticing benefits within a few weeks of regular participation

Recovery

Post-procedure Care and Instructions:

• Follow the prescribed lifestyle changes and dietary recommendations
• Regular follow-ups to track progress and make necessary adjustments

Expected Recovery Time:

• Continual process, with ongoing benefits as lifestyle changes are maintained

Restrictions or Follow-up Appointments:

• Scheduled follow-up visits to assess progress and support continued adherence to lifestyle changes

Alternatives

Other Treatment Options:

• Traditional cardiac rehabilitation programs including exercise
• Medication management without structured rehabilitation
• Surgical interventions for severe coronary artery disease

Pros and Cons of Alternatives:

• Traditional cardiac rehab: Includes exercise which can enhance heart health but may not be suitable for all patients
• Medications: Effective in managing symptoms but do not provide lifestyle education
• Surgery: Addresses severe issues but comes with higher risks and longer recovery

Patient Experience

During the Procedure:

• Patients will participate in interactive educational sessions and receive counseling support
• Minimal physical discomfort as no exercise or invasive procedures are involved

After the Procedure:

• Patients might feel more informed and empowered about managing their heart health
• Possible emotional relief from understanding and managing stress better

Pain Management and Comfort Measures:

• Psychological support available throughout the sessions
• Education paced according to patient comfort and understanding