Showing codes M1346 (Patients who did not have a net increase in pam score of at least 6 points within a 6 to 12 month period) — ME (The order for this service adheres to appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional)
M1346 - Pts no pam 6 pts 6-12 mo
Long description: Patients who did not have a net increase in pam score of at least 6 points within a 6 to 12 month 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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M1347 - Pt pam incr 3 pt 6-12 mo
Long description: Patients who achieved a net increase in pam score of at least 3 points in a 6 to 12 month period (passing)
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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M1348 - Pt pam incr 6 pt 6-12 mo
Long description: Patients who achieved a net increase in pam score of at least 6-points in a 6 to 12 month period (excellent)
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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M1349 - Pt no pam 3 pts 6-12 mo
Long description: Patients who did not have a net increase in pam score of at least 3 points within 6 to 12 month 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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M1350 - Pt w/ suic saf pln init rev
Long description: Patients who had a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical 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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M1351 - Pt cmplt suicd saf pln 120dy
Long description: Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation
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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M1352 - Suicd c-ssrs assessment, equ
Long description: Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment
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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M1353 - Pts no cmplt suicd saf pln
Long description: Patients who did not have a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical 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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M1354 - Pt no suicd saf pln 120dy
Long description: Patients who did not have a suicide safety plan initiated, reviewed, or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation
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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M1355 - Suicd based cln eval
Long description: Suicide risk based on their clinician's evaluation or a clinician-rated tool
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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M1356 - Pt died dur meas pd
Long description: Patients who died 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).
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M1357 - Pt w/red suic idea 120 days
Long description: Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment
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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M1359 - Indx suicd idea, no 0 scr
Long description: Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained
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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M1360 - Suicd c-ssrs assessment
Long description: Suicidal ideation and/or behavior symptoms based on the c-ssrs
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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M1361 - Suicd based cln eval
Long description: Suicide risk based on their clinician's evaluation or a clinician-rated tool
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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M1362 - Pt died dur meas pd
Long description: Patients who died 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).
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M1363 - Pts no f/u 120 dys
Long description: Patients who did not have a follow-up assessment within 120 days of the index assessment
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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M1364 - Ascvd risk >=20pct
Long description: Calculated 10-year ascvd risk score of >= 20 percent 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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M1365 - Hosp+pall care spec code 17
Long description: Patient encounter during the performance period with hospice and palliative care specialty code 17
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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M1366 - Focus on women's health mvp
Long description: Focusing on women's health mips value pathway
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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M1367 - Qual care ent disorder mvp
Long description: Quality care for the treatment of ear, nose, and throat disorders mips value pathway
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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M1368 - Prev trt inf d/o hiv/hep mvp
Long description: Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway
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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M1369 - Qualcare mental hlth/sud mvp
Long description: Quality care in mental health and substance use disorders mips value pathway
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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M1370 - Rehab support msk care mvp
Long description: Rehabilitative support for musculoskeletal care mips value pathway
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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M2 - Medicare secondary payer
Long description: Medicare secondary payer (msp)
Code added date: 20070101.
Code effective date: 20070101.
Coverage Code: C (A code denoting Medicare coverage status).
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MA - Emer med cond susp/confirm
Long description: Ordering professional is not required to consult a clinical decision support mechanism due to service being rendered to a patient with a suspected or confirmed emergency medical condition
Code added date: 20200101.
Code effective date: 20200101.
Coverage Code: C (A code denoting Medicare coverage status).
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MB - Auc hardship, insuf internet
Long description: Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of insufficient internet access
Code added date: 20200101.
Code effective date: 20200101.
Coverage Code: C (A code denoting Medicare coverage status).
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MC - Auc hardship, vendor issues
Long description: Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of electronic health record or clinical decision support mechanism vendor issues
Code added date: 20200101.
Code effective date: 20200101.
Coverage Code: C (A code denoting Medicare coverage status).
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MD - Auc hardship, extreme circ
Long description: Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of extreme and uncontrollable circumstances
Code added date: 20200101.
Code effective date: 20200101.
Coverage Code: C (A code denoting Medicare coverage status).
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ME - Order adheres to auc
Long description: The order for this service adheres to appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional
Code added date: 20200101.
Code effective date: 20200101.
Coverage Code: C (A code denoting Medicare coverage status).
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