Showing codes M1315 (Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified) — M1345 (Patients who had a baseline pam score and a second score within 6 to 12 month of baseline pam score)

M1315 - Crc no doc no rsn
Long description: Colorectal cancer screening 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).
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M1316 - Tobacco non-user
Long description: Current tobacco non-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).
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M1317 - Pts counsl cpt opt out
Long description: Patients who are counseled on connection with a csp and explicitly opt out
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).
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M1318 - Pts no csp doc contact
Long description: Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp
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).
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M1319 - Pts csp doc contact
Long description: Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening
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).
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M1320 - Pts scrn + hrsn
Long description: Patients who screened positive for at least 1 of the 5 hrsns
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).
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M1321 - Pts no 7wk inj,no iop,iop>25
Long description: Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg
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).
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M1322 - Pts 7wk inj, scrn iop =<25
Long description: Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye
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).
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M1323 - Pts 7wk inj, scrn iop >25
Long description: Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was 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).
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M1324 - Pts intravitreal/pci
Long description: Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)
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).
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M1325 - Doc med rsn not seen
Long description: Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within seven (7) weeks of treatment)
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).
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M1326 - Pts dx hypotony
Long description: Patients with a diagnosis of hypotony
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).
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M1327 - Pts no eval ini xm no 8 wks
Long description: Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks
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).
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M1328 - Pts dx acute vitreous hem
Long description: Patients with a diagnosis of acute vitreous hemorrhage
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).
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M1329 - Pts act pvd 2 wks 8 wks
Long description: Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd 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).
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M1330 - Doc pts rsn no f/u xm
Long description: Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)
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).
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M1331 - Pts eval ini xm 8 wks
Long description: Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam
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).
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M1332 - Pts no eval ini xm no 2 wks
Long description: Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks
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).
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M1333 - Acute vitreous hemorrhage
Long description: Acute vitreous hemorrhage
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).
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M1334 - Pts act pvd 2 wks 2 wks
Long description: Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd 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).
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M1335 - Doc pts rsn no f/u xm
Long description: Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)
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).
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M1336 - Pts eval ini xm 2 wks
Long description: Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks
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).
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M1337 - Acute pvd
Long description: Acute pvd
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).
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M1338 - Pt f/u 30-180 dys no + imprv
Long description: Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance 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).
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M1339 - Pts f/u 30-180 dys + improv
Long description: Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance 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).
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M1340 - Indx whodas 2.0 or sds
Long description: Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification 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).
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M1341 - Pt no f/u 30-180 dys
Long description: Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance 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).
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M1342 - Pts died perf per
Long description: Patients who died during the performance 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).
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M1343 - Pt pam lvl 4 base or srt lin
Long description: Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam
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).
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M1344 - Pts no bsln or 2nd pam score
Long description: Patients who did not have a baseline pam score and/or a second score within 6 to 12 month of baseline pam score
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).
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M1345 - Pt bsln pam, 2nd scr 6-12 mo
Long description: Patients who had a baseline pam score and a second score within 6 to 12 month of baseline pam score
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).
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