M codes: medical services and quality measures
482 codes, page 1 of 3.
Other codes in this group 200
| Code | Name | Status | Hospitals with prices |
|---|---|---|---|
| HCPCS M0001 | Advancing cancer care mips value pathways | Current code | |
| HCPCS M0002 | Optimal care for kidney health mips value pathways | Current code | |
| HCPCS M0003 | Optimal care for patients with episodic neurological conditions mips value pathways | Retired code | |
| HCPCS M0004 | Quality care for patients with neurological conditions mips value pathway | Current code | |
| HCPCS M0005 | Value in primary care mips value pathway | Current code | |
| HCPCS M0075 | Cellular therapy | Current code | |
| HCPCS M0076 | Prolotherapy | Current code | 15 hospitals |
| HCPCS M0100 | Intragastric hypothermia using gastric freezing | Current code | 9 hospitals |
| HCPCS M0231 | Intravenous infusion, tocilizumabbavi, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation only, includes infusion and post administration monitoring, first dose | Current code | |
| HCPCS M0232 | Intravenous infusion, tocilizumabbavi, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation only, includes infusion and post administration monitoring, second dose | Current code | |
| HCPCS M0233 | Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administration monitoring, first dose | Current code | 11 hospitals |
| HCPCS M0234 | Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administration monitoring, second dose | Current code | 11 hospitals |
| HCPCS M0300 | Iv chelation therapy (chemical endarterectomy) | Current code | 9 hospitals |
| HCPCS M0301 | Fabric wrapping of abdominal aneurysm | Current code | |
| HCPCS M1000 | Pain screened as moderate to severe | Retired code | |
| HCPCS M1001 | Plan of care to address moderate to severe pain documented on or before the date of the second visit with a clinician | Retired code | |
| HCPCS M1002 | Plan of care for moderate to severe pain not documented on or before the date of the second visit with a clinician, reason not given | Retired code | |
| HCPCS M1003 | Tb screening performed and results interpreted within twelve months prior to initiation of first-time biologic and/or immune response modifier therapy | Current code | |
| HCPCS M1004 | Documentation of medical reason for not screening for tb or interpreting results (i.e., patient positive for tb and documentation of past treatment; patient who has recently completed a course of anti-tb therapy) | Current code | |
| HCPCS M1005 | Tb screening not performed or results not interpreted, reason not given | Current code | |
| HCPCS M1006 | Disease activity not assessed, reason not given | Current code | |
| HCPCS M1007 | >=50% of total number of a patient's outpatient ra encounters assessed | Current code | |
| HCPCS M1008 | <50% of total number of a patient's outpatient ra encounters assessed | Current code | |
| HCPCS M1009 | Discharge/discontinuation of the episode of care documented in the medical record | Current code | |
| HCPCS M1010 | Discharge/discontinuation of the episode of care documented in the medical record | Current code | |
| HCPCS M1011 | Discharge/discontinuation of the episode of care documented in the medical record | Current code | |
| HCPCS M1012 | Discharge/discontinuation of the episode of care documented in the medical record | Current code | |
| HCPCS M1013 | Discharge/discontinuation of the episode of care documented in the medical record | Current code | |
| HCPCS M1014 | Discharge/discontinuation of the episode of care documented in the medical record | Current code | |
| HCPCS M1015 | Discharge/discontinuation of the episode of care documented in the medical record | Retired code | |
| HCPCS M1016 | Female patients unable to bear children | Current code | |
| HCPCS M1017 | Patient admitted to palliative care services | Retired code | |
| HCPCS M1018 | Patients with an active diagnosis or history of cancer (except basal cell and squamous cell skin carcinoma), patients who are heavy tobacco smokers, lung cancer screening patients | Current code | |
| HCPCS M1019 | Adolescent patients 12 to 17 years of age with major depression or dysthymia who reached remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5 | Current code | |
| HCPCS M1020 | Adolescent patients 12 to 17 years of age with major depression or dysthymia who did not reach remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5. either phq-9 or phq-9m score was not assessed or is greater than or equal to 5 | Current code | |
| HCPCS M1021 | Patient had only urgent care visits during the performance period | Current code | |
| HCPCS M1022 | Patients who were in hospice at any time during the performance period | Retired code | |
| HCPCS M1023 | Adolescent patients 12 to 17 years of age with major depression or dysthymia who reached remission at six months as demonstrated by a six month (+/-60 days) phq-9 or phq-9m score of less than five | Retired code | |
| HCPCS M1024 | Adolescent patients 12 to 17 years of age with major depression or dysthymia who did not reach remission at six months as demonstrated by a six month (+/-60 days) phq-9 or phq-9m score of less than five. either phq-9 or phq-9m score was not assessed or is greater than or equal to five | Retired code | |
| HCPCS M1025 | Patients who were in hospice at any time during the performance period | Retired code | |
| HCPCS M1026 | Patients who were in hospice at any time during the performance period | Retired code | |
| HCPCS M1027 | Imaging of the head (ct or mri) was obtained | Current code | |
| HCPCS M1028 | Documentation of patients with primary headache diagnosis and imaging other than ct or mri obtained | Current code | |
| HCPCS M1029 | Imaging of the head (ct or mri) was not obtained, reason not given | Current code | |
| HCPCS M1030 | Patients with clinical indications for imaging of the head | Retired code | |
| HCPCS M1031 | Patients with no clinical indications for imaging of the head | Retired code | |
| HCPCS M1032 | Adults currently taking pharmacotherapy for oud | Current code | |
| HCPCS M1033 | Pharmacotherapy for oud initiated after june 30th of performance period | Retired code | |
| HCPCS M1034 | Adults who have at least 180 days of continuous pharmacotherapy with a medication prescribed for oud without a gap of more than seven days | Current code | |
| HCPCS M1035 | Adults who are deliberately phased out of medication assisted treatment (mat) prior to 180 days of continuous treatment | Current code | |
| HCPCS M1036 | Adults who have not had at least 180 days of continuous pharmacotherapy with a medication prescribed for oud without a gap of more than seven days | Current code | |
| HCPCS M1037 | Patients with a diagnosis of lumbar spine region cancer at the time of the procedure | Current code | |
| HCPCS M1038 | Patients with a diagnosis of lumbar spine region fracture at the time of the procedure | Current code | |
| HCPCS M1039 | Patients with a diagnosis of lumbar spine region infection at the time of the procedure | Current code | |
| HCPCS M1040 | Patients with a diagnosis of lumbar idiopathic or congenital scoliosis | Current code | |
| HCPCS M1041 | Patient had cancer, acute fracture or infection related to the lumbar spine or patient had neuromuscular, idiopathic or congenital lumbar scoliosis | Current code | |
| HCPCS M1042 | Functional status measurement with score was obtained utilizing the oswestry disability index (odi version 2.1a) patient reported outcome tool within three months preoperatively and at one year (9 to 15 months) postoperatively | Retired code | |
| HCPCS M1043 | Functional status was not measured by the oswestry disability index (odi version 2.1a) at one year (9 to 15 months) postoperatively | Current code | |
| HCPCS M1044 | Functional status was measured by the oswestry disability index (odi version 2.1a) patient reported outcome tool within three months preoperatively and at one year (9 to 15 months) postoperatively | Retired code | |
| HCPCS M1045 | Functional status measured by the oxford knee score (oks) at one year (9 to 15 months) postoperatively was greater than or equal to 37 or knee injury and osteoarthritis outcome score joint replacement (koos, jr.) was greater than or equal to 71 | Current code | |
| HCPCS M1046 | Functional status measured by the oxford knee score (oks) at one year (9 to 15 months) postoperatively was less than 37 or the knee injury and osteoarthritis outcome score joint replacement (koos, jr.) was less than 71 postoperatively | Current code | |
| HCPCS M1047 | Functional status was measured by the oxford knee score (oks) patient reported outcome tool within three months preoperatively and at one year (9 to 15 months) postoperatively | Retired code | |
| HCPCS M1048 | Functional status measurement with score was obtained utilizing the oswestry disability index (odi version 2.1a) patient reported outcome tool within three months preoperatively and at three months (6 to 20 weeks) postoperatively | Retired code | |
| HCPCS M1049 | Functional status was not measured by the oswestry disability index (odi version 2.1a) at three months (6 - 20 weeks) postoperatively | Current code | |
| HCPCS M1050 | Functional status was measured by the oswestry disability index (odi version 2.1a) patient reported outcome tool within three months preoperatively and at three months (6 to 20 weeks) postoperatively | Retired code | |
| HCPCS M1051 | Patient had cancer, acute fracture or infection related to the lumbar spine or patient had neuromuscular, idiopathic or congenital lumbar scoliosis | Current code | |
| HCPCS M1052 | Leg pain was not measured by the visual analog scale (vas) or numeric pain scale at one year (9 to 15 months) postoperatively | Current code | |
| HCPCS M1053 | Leg pain was measured by the visual analog scale (vas) within three months preoperatively and at one year (9 to 15 months) postoperatively | Retired code | |
| HCPCS M1054 | Patient had only urgent care visits during the performance period | Current code | |
| HCPCS M1055 | Aspirin or another antiplatelet therapy used | Current code | |
| HCPCS M1056 | Prescribed anticoagulant medication during the performance period, history of gi bleeding, history of intracranial bleeding, bleeding disorder and specific provider documented reasons: allergy to aspirin or anti-platelets, use of non-steroidal anti-inflammatory agents, drug-drug interaction, uncontrolled hypertension > 180/110 mmhg or gastroesophageal reflux disease | Current code | |
| HCPCS M1057 | Aspirin or another antiplatelet therapy not used, reason not given | Current code | |
| HCPCS M1058 | Patient was a permanent nursing home resident at any time during the performance period | Current code | |
| HCPCS M1059 | Patient was in hospice or receiving palliative care at any time during the performance period | Current code | |
| HCPCS M1060 | Patient died prior to the end of the performance period | Current code | |
| HCPCS M1061 | Patient pregnancy | Retired code | |
| HCPCS M1062 | Patient immunocompromised | Retired code | |
| HCPCS M1063 | Patients receiving high doses of immunosuppressive therapy | Retired code | |
| HCPCS M1064 | Shingrix vaccine documented as administered or previously received | Retired code | |
| HCPCS M1065 | Shingrix vaccine was not administered for reasons documented by clinician (e.g. patient administered vaccine other than shingrix, patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) | Retired code | |
| HCPCS M1066 | Shingrix vaccine not documented as administered, reason not given | Retired code | |
| HCPCS M1067 | Hospice services for patient provided any time during the measurement period | Current code | |
| HCPCS M1068 | Adults who are not ambulatory | Current code | |
| HCPCS M1069 | Patient screened for future fall risk | Current code | |
| HCPCS M1070 | Patient not screened for future fall risk, reason not given | Current code | |
| HCPCS M1071 | Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy | Retired code | |
| HCPCS M1106 | The start of an episode of care documented in the medical record | Current code | |
| HCPCS M1107 | Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care | Current code | |
| HCPCS M1108 | Ongoing care not clinically indicated because the patient needed a home program only, referral to another provider or facility, or consultation only, as documented in the medical record | Current code | |
| HCPCS M1109 | Ongoing care not medically possible because the patient was discharged early due to specific medical events, documented in the medical record, such as the patient became hospitalized or scheduled for surgery | Current code | |
| HCPCS M1110 | Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown) | Current code | |
| HCPCS M1111 | The start of an episode of care documented in the medical record | Current code | |
| HCPCS M1112 | Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care | Current code | |
| HCPCS M1113 | Ongoing care not clinically indicated because the patient needed a home program only, referral to another provider or facility, or consultation only, as documented in the medical record | Current code | |
| HCPCS M1114 | Ongoing care not medically possible because the patient was discharged early due to specific medical events, documented in the medical record, such as the patient became hospitalized or scheduled for surgery | Current code | |
| HCPCS M1115 | Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown) | Current code | |
| HCPCS M1116 | The start of an episode of care documented in the medical record | Current code | |
| HCPCS M1117 | Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care | Current code | |
| HCPCS M1118 | Ongoing care not clinically indicated because the patient needed a home program only, referral to another provider or facility, or consultation only, as documented in the medical record | Current code | |
| HCPCS M1119 | Ongoing care not medically possible because the patient was discharged early due to specific medical events, documented in the medical record, such as the patient became hospitalized or scheduled for surgery | Current code | |
| HCPCS M1120 | Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown) | Current code | |
| HCPCS M1121 | The start of an episode of care documented in the medical record | Current code | |
| HCPCS M1122 | Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care | Current code | |
| HCPCS M1123 | Ongoing care not clinically indicated because the patient needed a home program only, referral to another provider or facility, or consultation only, as documented in the medical record | Current code | |
| HCPCS M1124 | Ongoing care not medically possible because the patient was discharged early due to specific medical events, documented in the medical record, such as the patient became hospitalized or scheduled for surgery | Current code | |
| HCPCS M1125 | Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown) | Current code | |
| HCPCS M1126 | The start of an episode of care documented in the medical record | Current code | |
| HCPCS M1127 | Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care | Current code | |
| HCPCS M1128 | Ongoing care not clinically indicated because the patient needed a home program only, referral to another provider or facility, or consultation only, as documented in the medical record | Current code | |
| HCPCS M1129 | Ongoing care not medically possible because the patient was discharged early due to specific medical events, documented in the medical record, such as the patient became hospitalized or scheduled for surgery | Current code | |
| HCPCS M1130 | Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown) | Current code | |
| HCPCS M1131 | Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care | Current code | |
| HCPCS M1132 | Ongoing care not clinically indicated because the patient needed a home program only, referral to another provider or facility, or consultation only, as documented in the medical record | Current code | |
| HCPCS M1133 | Ongoing care not medically possible because the patient was discharged early due to specific medical events, documented in the medical record, such as the patient became hospitalized or scheduled for surgery | Current code | |
| HCPCS M1134 | Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown) | Current code | |
| HCPCS M1135 | The start of an episode of care documented in the medical record | Current code | |
| HCPCS M1136 | The start of an episode of care documented in the medical record | Retired code | |
| HCPCS M1137 | Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care | Retired code | |
| HCPCS M1138 | Ongoing care not indicated, patient seen only 1-2 visits (e.g., home program only, referred to another provider or facility, consultation only) | Retired code | |
| HCPCS M1139 | Ongoing care not indicated, patient self-discharged early and seen only 1-2 visits (e.g., financial or insurance reasons, transportation problems, or reason unknown) | Retired code | |
| HCPCS M1140 | Ongoing care not indicated, patient discharged after only 1-2 visits due to specific medical events, documented in the medical record that make the treatment episode impossible such as the patient becomes hospitalized or scheduled for surgery for surgery or hospitalized | Retired code | |
| HCPCS M1141 | Functional status was not measured by the oxford knee score (oks) or the knee injury and osteoarthritis outcome score joint replacement (koos, jr.) at one year (9 to 15 months) postoperatively | Current code | |
| HCPCS M1142 | Emergent cases | Current code | |
| HCPCS M1143 | Initiated episode of rehabilitation therapy, medical, or chiropractic care for neck impairment | Current code | |
| HCPCS M1144 | Ongoing care not indicated, patient seen only 1-2 visits (e.g., home program only, referred to another provider or facility, consultation only | Retired code | |
| HCPCS M1146 | Ongoing care not clinically indicated because the patient needed a home program only, referral to another provider or facility, or consultation only, as documented in the medical record | Current code | |
| HCPCS M1147 | Ongoing care not medically possible because the patient was discharged early due to specific medical events, documented in the medical record, such as the patient became hospitalized or scheduled for surgery | Current code | |
| HCPCS M1148 | Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown) | Current code | |
| HCPCS M1149 | Patient unable to complete the neck fs prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility, and an adequate proxy is not available | Current code | |
| HCPCS M1150 | Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function | Current code | |
| HCPCS M1151 | Patients with a history of heart transplant or with a left ventricular assist device (lvad) | Current code | |
| HCPCS M1152 | Patients with a history of heart transplant or with a left ventricular assist device (lvad) | Current code | |
| HCPCS M1153 | Patient with diagnosis of osteoporosis on date of encounter | Current code | |
| HCPCS M1154 | Hospice services provided to patient any time during the measurement period | Retired code | |
| HCPCS M1155 | Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period | Retired code | |
| HCPCS M1156 | Patient received active chemotherapy any time during the measurement period | Retired code | |
| HCPCS M1157 | Patient received bone marrow transplant any time during the measurement period | Retired code | |
| HCPCS M1158 | Patient had history of immunocompromising conditions prior to or during the measurement period | Retired code | |
| HCPCS M1159 | Hospice services provided to patient any time during the measurement period | Current code | |
| HCPCS M1160 | Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patient's 13th birthday | Current code | |
| HCPCS M1161 | Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patient's 13th birthday | Current code | |
| HCPCS M1162 | Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patient's 13th birthday | Current code | |
| HCPCS M1163 | Patient had anaphylaxis due to the hpv vaccine any time on or before the patient's 13th birthday | Current code | |
| HCPCS M1164 | Patients with dementia any time during the patient's history through the end of the measurement period | Current code | |
| HCPCS M1165 | Patients who use hospice services any time during the measurement period | Current code | |
| HCPCS M1166 | Pathology report for tissue specimens produced from wide local excisions or re-excisions | Current code | |
| HCPCS M1167 | In hospice or using hospice services during the measurement period | Current code | |
| HCPCS M1168 | Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period | Current code | |
| HCPCS M1169 | Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine) | Current code | |
| HCPCS M1170 | Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period | Current code | |
| HCPCS M1171 | Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period | Current code | |
| HCPCS M1172 | Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine) | Current code | |
| HCPCS M1173 | Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period | Current code | |
| HCPCS M1174 | Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period | Current code | |
| HCPCS M1175 | Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine) | Current code | |
| HCPCS M1176 | Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period | Current code | |
| HCPCS M1177 | Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period | Current code | |
| HCPCS M1178 | Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine) | Current code | |
| HCPCS M1179 | Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period | Current code | |
| HCPCS M1180 | Patients on immune checkpoint inhibitor therapy | Current code | |
| HCPCS M1181 | Grade 2 or above diarrhea and/or grade 2 or above colitis | Current code | |
| HCPCS M1182 | Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohn's disease) | Current code | |
| HCPCS M1183 | Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered | Current code | |
| HCPCS M1184 | Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting diagnostic workup results for alternative etiologies, other medical reasons/contraindication) | Current code | |
| HCPCS M1185 | Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given | Current code | |
| HCPCS M1186 | Patients who have an order for or are receiving hospice or palliative care | Current code | |
| HCPCS M1187 | Patients with a diagnosis of end stage renal disease (esrd) | Current code | |
| HCPCS M1188 | Patients with a diagnosis of chronic kidney disease (ckd) stage 5 | Current code | |
| HCPCS M1189 | Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed | Current code | |
| HCPCS M1190 | Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) | Current code | |
| HCPCS M1191 | Hospice services provided to patient any time during the measurement period | Current code | |
| HCPCS M1192 | Patients with an existing diagnosis of squamous cell carcinoma of the esophagus | Current code | |
| HCPCS M1193 | Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both | Current code | |
| HCPCS M1194 | Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therapy, no residual carcinoma is present in the sample [tissue exhausted or status post neoadjuvant treatment], insufficient tumor for testing) | Current code | |
| HCPCS M1195 | Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given | Current code | |
| HCPCS M1196 | Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4 | Current code | |
| HCPCS M1197 | Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score | Current code | |
| HCPCS M1198 | Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter | Current code | |
| HCPCS M1199 | Patients receiving rrt | Current code | |
| HCPCS M1200 | Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period | Current code | |
| HCPCS M1201 | Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other allergy to ace-i and arb, hyperkalemia or history of hyperkalemia while on ace-i or arb therapy, acute kidney injury due to ace-i or arb therapy), other medical reasons) | Current code | |
| HCPCS M1202 | Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons) | Current code | |
| HCPCS M1203 | Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given | Current code | |
| HCPCS M1204 | Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4 | Current code | |
| HCPCS M1205 | Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score | Current code | |
| HCPCS M1206 | Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter | Current code | |
| HCPCS M1207 | Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety | Current code | |
| HCPCS M1208 | Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety | Current code | |
| HCPCS M1209 | At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses | Current code | |
| HCPCS M1210 | At least two orders for high-risk medications from the same drug class, (table 4), not ordered | Current code | |
| HCPCS M1211 | Most recent glycemic status assessment (hba1c or gmi) level > 9.0% | Current code | |
| HCPCS M1212 | Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period | Current code | |
| HCPCS M1213 | No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70% | Current code | |
| HCPCS M1214 | Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed | Current code | |
| HCPCS M1215 | Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy) | Current code | |
| HCPCS M1216 | No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter | Current code | |
| HCPCS M1217 | Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter) | Current code | |
| HCPCS M1218 | Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing) | Current code | |
| HCPCS M1219 | Anaphylaxis due to the vaccine on or before the date of the encounter | Retired code | |
| HCPCS M1220 | Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy | Current code |