Showing codes M1243 (Patient provided a response other than "completely true" for the question of patient felt heard and understood by this provider and team) — M1273 (Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form)
M1243 - Pt othr thn true heard
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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M1244 - Pt othr thn true best int
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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M1245 - Pt othr thn true person
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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M1246 - Pt othr thn true imprt to me
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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M1247 - Pt resp true best int
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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M1248 - Pt resp true seen as person
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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PDF
M1249 - Pt resp true imprt to me
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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PDF
M1250 - Pt resp true heard
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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M1251 - Pts proxy cmplt hu surv
Long description: Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)
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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M1252 - Pts no cmplt hu survey
Long description: Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit
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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M1253 - Pts hu surv no amb plltv
Long description: Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)
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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M1254 - Pts deceased prior hu surv
Long description: Patients who were deceased when the hu survey reached them
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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M1255 - Pts w/ othr rsn vst,+prg tst
Long description: Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)
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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M1256 - Prior history of known cvd
Long description: Prior history of known cvd
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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M1257 - Cvd risk assess not perf
Long description: Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), 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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M1258 - Cvd risk assess perf
Long description: Cvd risk assessment performed, have a documented calculated risk 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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M1259 - Pt stat doc <= 1 yr dialysis
Long description: Patient status documented within the first year of initiating dialysis
Code added date: 20240101.
Code effective date: 20250101.
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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M1260 - Pt not doc <= 1 yr dialysis
Long description: Patient status not documented within the first year of initiating dialysis
Code added date: 20240101.
Code effective date: 20250101.
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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PDF
M1261 - Pts on wtlist bef dialysis
Long description: Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis
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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M1262 - Pts transplt bef dialysis
Long description: Patients who had a transplant prior to initiation of dialysis
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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M1263 - Pts hosp dialysis dt
Long description: Patients in hospice on their initiation of dialysis date or during the month of evaluation
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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M1264 - Pts 75+ dialysis dt
Long description: Patients age 75 or older on their initiation of dialysis date
Code added date: 20240101.
Code effective date: 20250101.
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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M1265 - Cms 2728 completed
Long description: Cms medical evidence form 2728 for dialysis patients: initial form completed
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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PDF
M1266 - Pts admit snf
Long description: Patients admitted to a skilled nursing facility (snf)
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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PDF
M1267 - Pt no act kid transplt wtlst
Long description: Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period
Code added date: 20240101.
Code effective date: 20250101.
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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PDF
M1268 - Pt ac stat kid trnsplt wtlst
Long description: Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period
Code added date: 20240101.
Code effective date: 20250101.
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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PDF
M1269 - Rec'd esrd mcp lst day of mo
Long description: Receiving esrd mcp dialysis services by the provider on the last day of the reporting month
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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PDF
M1270 - Pts no kid transplt wtlst
Long description: Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month 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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PDF
M1271 - Pts dem any time/dur mo
Long description: Patients with dementia at any time prior to or during the month
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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PDF
M1272 - Pts kid transplt wtlst
Long description: Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period
Code added date: 20240101.
Code effective date: 20250101.
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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PDF
M1273 - Pts snf 1 yr dialysis
Long description: Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form
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