Section 4.2.3 standard benefit, Section 4.2.3.b extension provision
Prior Authorization PA-2026-MH-8832
Authorization SystemApproved: 10 Apr 2026
Used in 1 trace
Original 36-session authorization for cardiac rehab post-CABG
Clinical Progress Notes — Dr. Robert Kim
Valley Heart Associates
Source: EHR System · Last updated: 28 Jul 2026
Used by 2 Brain operations
Progress Note — Cardiac Rehabilitation
M-8832 · 28 Jul 2026
Member M-8832 · 62M · s/p CABG (Apr 2026) · Provider: Dr. Robert Kim, MD
Assessment
62-year-old male enrolled in Phase II cardiac rehabilitation following coronary artery bypass grafting. Has completed the standard 36-session course. Progress is steady but functional recovery remains incomplete relative to age- and procedure-based targets.
Functional capacity: 5.2 METs (target 7.0 METs for age and procedure)
Used in EB-HP-02341, Step 3
Objective Findings
Serial exercise tolerance testing across the rehabilitation course demonstrates a consistent upward trajectory, though the patient has not yet reached the functional target.