Summary & Overview
CPT 1012F: Therapeutic Management for CAD, Angina-Free Status
CPT code 1012F documents therapeutic management for patients with coronary artery disease (CAD) when a clinician evaluates activity level and symptoms and determines the patient is free of angina. This code signals targeted clinical assessment of symptom control in ambulatory cardiology care and supports quality measurement of angina-free status in chronic CAD management. Nationally, documenting angina status influences care coordination, follow-up intensity, and quality reporting across payers.
Key payers referenced include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an explanation of what the code represents, the clinical context for use, and how its documentation informs performance measurement and care pathways. The publication outlines expected service settings and the clinical rationale for tracking angina-free status as part of CAD management.
The report provides benchmarks and practical guidance on documentation expectations, notes policy or coding clarifications where available, and situates the code within broader clinical workflows for outpatient cardiology and chronic disease management. Data not available in the input is identified where applicable.
Billing Code Overview
CPT code 1012F denotes therapeutic management provided to a patient with coronary artery disease (CAD) in which the clinician evaluates the patient’s activity level and symptoms and documents that the patient is without angina (chest pain). This code captures a clinical assessment focused on symptom status and functional activity related to CAD.
Service type: Therapeutic management / clinical evaluation for chronic cardiac condition
Typical site of service: Outpatient clinic or office-based cardiology visits
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with established coronary artery disease (prior percutaneous coronary intervention, on aspirin and statin) presents for a routine cardiology follow-up visit. He reports no chest pain, no exertional angina, and no recent dyspnea with activities. The cardiologist reviews interval history, current medications, activity level, and any exercise tolerance or limitations. Vital signs are stable and a focused cardiovascular examination is unremarkable. The provider documents therapeutic management for coronary artery disease and concludes, after assessment of symptoms and activity, that the patient is without angina. The clinical workflow includes history focused on angina symptoms, assessment of functional status, medication reconciliation, and counseling regarding risk factor control and activity guidance. Typical site of service is an outpatient cardiology clinic or an ambulatory care setting where chronic cardiovascular disease management is performed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the same day of a procedure | Use when a significant E/M visit is performed on the same day as another procedure unrelated to the CAD management visit |
26 | Professional component | Use if billing only the physician’s professional component when a facility bills the technical component |
57 | Decision for surgery | Use when the E/M visit results in the decision to perform surgery (rare for routine CAD stability visit) |
59 | Distinct procedural service | Use to indicate a distinct service when multiple unrelated services are billed the same day |
24 | Unrelated E/M by same physician during postoperative period | Use when this management visit is unrelated to a prior surgical postoperative period |
52 | Reduced services | Use if the service provided is reduced or interrupted and needs reporting of reduced service |
A1 | Principal physician after transfer | Use when the managing physician continues care after transfer from another physician (facility transfers) when applicable |
GC | Service performed by resident under teaching physician | Use when a resident performs the service and the teaching physician documents presence |
GQ | Telehealth via asynchronous telecommunications | Use when telemedicine encounter is delivered via asynchronous store-and-forward (where allowed) |
95 | Synchronous telemedicine service rendered via real-time interactive audio and video | Use when the CAD management visit is performed via live telehealth |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207RC0000X | Cardiology | Interventional and non-interventional cardiologists provide CAD management and therapeutic evaluation |
| 207RP0012X | Internal Medicine/Cardiology | Hospital-based or clinic-based cardiology practices managing chronic CAD |
| 207Q00000X | Family Medicine | Primary care physicians who manage stable CAD patients and perform therapeutic management |
| 207R00000X | Internal Medicine | General internists providing longitudinal CAD care in ambulatory settings |
| 2080P0207X | Nurse Practitioner - Cardiology | Advanced practice providers who perform CAD follow-up and therapeutic management |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
I25.10 | Atherosclerotic heart disease of native coronary artery without angina pectoris | Primary diagnosis for stable CAD patients without angina; directly aligns with therapeutic management described |
I25.110 | Atherosclerotic heart disease of native coronary artery with unstable angina | Included to distinguish angina status; documentation must confirm absence of angina for 1012F |
I25.2 | Old myocardial infarction | Relevant in CAD follow-up; prior MI influences secondary prevention and therapeutic decisions |
I20.9 | Angina pectoris, unspecified | Used when angina status is uncertain; documentation should clarify absence to support 1012F |
Z79.01 | Long term (current) use of antithrombotic/antiplatelet drugs | Medication use commonly documented during CAD management visits and relevant to risk management |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | Often used when a detailed history and moderate-complexity decision-making accompanies CAD management when angina is absent |
93000 | Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report | Commonly performed alongside CAD follow-up to assess rhythm and ischemic changes |
93306 | Echocardiography, transthoracic, real-time with image documentation (2D), complete, with spectral and color Doppler | Performed when assessment of cardiac function or new symptoms is needed despite absence of angina |
93010 | Electrocardiogram interpretation and report only | Billed when ECG tracing is done by facility and physician bills for interpretation related to CAD management |
99454 | Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified healthcare professional time in a calendar month requiring interactive communication with the patient/caregiver during the month | Used when remote monitoring of cardiac parameters supports ongoing therapeutic management of CAD |