Showing codes M1284 (Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period) — M1314 (Bmi not documented and no reason is given)

M1284 - Pt 66+ snp or ltc pos > 90d
Long description: Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period
Code added date: 20240101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

M1285 - Scrn mam perf rslts not doc
Long description: Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified
Code added date: 20240101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

M1286 - Bmi doc onl fup not cmpltd
Long description: Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason
Code added date: 20240101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

M1287 - Calc bmi blw low param f/u
Long description: Bmi is documented below normal parameters and a follow-up plan is documented
Code added date: 20240101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

M1288 - Doc rsn no hbp scrn or f/u
Long description: Documented reason for not screening or recommending a follow-up for high blood pressure
Code added date: 20240101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

M1289 - No pt tbco cess interv rng
Long description: Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)
Code added date: 20240101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

M1290 - Pt not eli d/t act dig htn
Long description: Patient not eligible due to active diagnosis of hypertension
Code added date: 20240101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

M1291 - Pt 66+ frailty and med dem
Long description: Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period
Code added date: 20240101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

M1292 - Pt 66+ frail inpt adv ill
Long description: Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period
Code added date: 20240101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

M1293 - Calc bmi abv up param f/u
Long description: Bmi is documented above normal parameters and a follow-up plan is documented
Code added date: 20240101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

M1294 - Bp scrn perf rec interval
Long description: Normal blood pressure reading documented, follow-up not required
Code added date: 20240101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

M1295 - Pt hx tot col or colon ca
Long description: Patients with a diagnosis or past history of total colectomy or colorectal cancer
Code added date: 20240101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

M1296 - Calc bmi norm parameters
Long description: Bmi is documented within normal parameters and no follow-up plan is required
Code added date: 20240101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

M1297 - Bmi not doc medrsn ptref
Long description: Bmi not documented due to medical reason or patient refusal of height or weight measurement
Code added date: 20240101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

M1298 - Doc pt preg dur msrmt pd
Long description: Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter
Code added date: 20240101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

M1299 - Flu immunize order/admin
Long description: Influenza immunization administered or previously received
Code added date: 20240101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

M1300 - Flu imm no admin doc rea
Long description: Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)
Code added date: 20240101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

M1301 - Pt recv tbco cess interv
Long description: Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)
Code added date: 20240101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

M1302 - Scrn mam perf rslts doc
Long description: Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed
Code added date: 20240101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

M1303 - Hospc serv dur meas pd
Long description: Hospice services provided to patient any time during the measurement period
Code added date: 20240101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

M1304 - No pneum vax admin 19+
Long description: Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period
Code added date: 20240101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

M1305 - Pneum vax admin 19+
Long description: Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period
Code added date: 20240101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

M1306 - Pt anphx due to pneum
Long description: Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period
Code added date: 20240101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

M1307 - Doc pt pal or hospice
Long description: Documentation stating the patient has received or is currently receiving palliative or hospice care
Code added date: 20240101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

M1308 - Flu immunize no admin
Long description: Influenza immunization was not administered, reason not given
Code added date: 20240101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

M1309 - Pall serv during meas
Long description: Palliative care services provided to patient any time during the measurement period
Code added date: 20240101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

M1310 - Pt scr tob & cess int
Long description: Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user
Code added date: 20240101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

M1311 - Aphlx to vax bef enc
Long description: Anaphylaxis due to the vaccine on or before the date of the encounter
Code added date: 20240101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

M1312 - No pt tbco scrn rng
Long description: Patient not screened for tobacco use
Code added date: 20240101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

M1313 - No tob scr/cess int
Long description: Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period
Code added date: 20240101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

M1314 - Bmi not calculated
Long description: Bmi not documented and no reason is given
Code added date: 20240101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF