Summary & Overview
HCPCS S0341: Lifestyle Modification Program for Coronary Artery Disease, Stage 2-3
HCPCS Level II code S0341 designates a lifestyle modification program for the management of coronary artery disease during the second or third quarter/stage of treatment. This code captures structured secondary prevention services including behavioral counseling, risk-factor management, patient education, and other supportive interventions intended to reduce recurrent cardiovascular events. Nationally, codes like S0341 matter because they identify non-procedural, longitudinal care that supports cardiac rehabilitation goals and population health initiatives focused on reducing readmissions and improving long-term outcomes.
Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for the code, typical sites of service, and the program elements it represents. The publication also summarizes payer coverage considerations, common billing modifiers, and where this code fits within cardiac rehabilitation and secondary prevention service lines. Policy updates and benchmark-oriented discussion will cover how payers treat service staging and supportive services captured by S0341, and clarify documentation elements commonly associated with longitudinal lifestyle modification programs.
This piece is intended for national audiences including billing professionals, health policy analysts, and clinical leaders seeking a focused reference on HCPCS Level II code S0341 and its role in coronary artery disease management.
Billing Code Overview
HCPCS Level II code S0341 represents a lifestyle modification program for management of coronary artery disease, encompassing all supportive services provided during the second or third quarter / stage of the program. The code denotes ongoing structured interventions focused on risk-factor reduction, behavioral counseling, education, and other supportive components aimed at secondary prevention for patients with coronary artery disease.
Service type: Lifestyle modification program, secondary prevention for coronary artery disease
Typical site of service: Outpatient clinic or ambulatory cardiac rehabilitation setting; may also be delivered in community-based or home health settings when appropriate
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A 62-year-old male with stable ischemic heart disease is enrolled in a structured cardiac lifestyle modification program after recent percutaneous coronary intervention. During the second or third quarter/stage of the program, the multidisciplinary team provides ongoing risk-factor counseling, exercise progression monitoring, dietary reinforcement, smoking cessation support, psychosocial assessment, medication adherence review, and coordination of community resources. Typical workflow: referral from cardiology or primary care; initial assessment by a nurse or cardiac rehabilitation coordinator; individualized care plan with scheduled sessions across quarters/stages; periodic face-to-face or telehealth counseling visits, exercise supervision by cardiac rehab staff or exercise physiologist, and documentation of progress and barriers. Visits are billable under S0341 for the second or third quarter/stage and commonly occur in outpatient hospital-based cardiac rehabilitation centers, freestanding cardiac rehabilitation clinics, or physician offices with structured secondary prevention services. Billing often accompanies ICD-10 diagnoses indicating coronary artery disease and post-procedural status, and may be appended with appropriate modifiers to indicate unusual circumstances (for example increased complexity or telehealth delivery). Payors commonly involved include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 |