Showing codes M1398 (Patients with baseline and follow-up promis surveys documented in the medical record) — MB (Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of insufficient internet access)

M1398 - Bslne and fu promis doc
Long description: Patients with baseline and follow-up promis surveys documented in the medical record
Code added date: 20250101.
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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M1399 - Pt lve prac
Long description: Patients who leave the practice during the follow-up period
Code added date: 20250101.
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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M1400 - Pt died dur perf pd
Long description: Patients who died during the follow-up period
Code added date: 20250101.
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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M1401 - Stg i-iii br ca
Long description: Stages i-iii breast cancer
Code added date: 20250101.
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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M1402 - Init chemo w/def dur ec grp
Long description: Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group
Code added date: 20250101.
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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M1403 - Bslne and fu promis doc
Long description: Patients with baseline and follow-up promis surveys documented in the medical record
Code added date: 20250101.
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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M1404 - Pt ther clin trial
Long description: Patients on a therapeutic clinical trial
Code added date: 20250101.
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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M1405 - Pt w/ recur/prog
Long description: Patients with recurrence/disease progression
Code added date: 20250101.
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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M1406 - Pt lve prac
Long description: Patients who leave the practice during the follow-up period
Code added date: 20250101.
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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M1407 - Pt died dur perf pd
Long description: Patients who died during the follow-up period
Code added date: 20250101.
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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M1408 - Gmln brca bef dx ca
Long description: Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer
Code added date: 20250101.
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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M1409 - Recd gmln brca1/brca2 couns
Long description: Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis
Code added date: 20250101.
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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M1410 - No gmln brca1/brca2 couns
Long description: Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis
Code added date: 20250101.
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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M1411 - 1st ln ici no chemo
Long description: Currently on first-line immune checkpoint inhibitors without chemotherapy
Code added date: 20250101.
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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M1412 - Met nsclc w/ egfr alk oth ab
Long description: Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skipping mutation, and ret rearrangement
Code added date: 20250101.
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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M1413 - Pos pdl1 bef init ici tx
Long description: Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy
Code added date: 20250101.
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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M1414 - Med rsn no pdl1 bef 1st ther
Long description: Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patient's health status; other medical reasons/contraindication)
Code added date: 20250101.
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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M1415 - No pos pdl1 bef ici ther
Long description: Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy
Code added date: 20250101.
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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M1416 - Pt rec hosp
Long description: Patient received hospice services any time during the performance period
Code added date: 20250101.
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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M1417 - Pt up to date cov
Long description: Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination
Code added date: 20250101.
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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M1418 - Med rsn not up to date cov
Long description: Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by clinician
Code added date: 20250101.
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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M1419 - Pt not up to date cov
Long description: Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination
Code added date: 20250101.
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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M1420 - Complete ophthalmologic mvp
Long description: Complete ophthalmologic care mips value pathway
Code added date: 20250101.
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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M1421 - Dermatological care mvp
Long description: Dermatological care mips value pathway
Code added date: 20250101.
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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M1422 - Gastroenterology care mvp
Long description: Gastroenterology care mips value pathway
Code added date: 20250101.
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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M1423 - Opt care urologic cnd mvp
Long description: Optimal care for patients with urologic conditions mips value pathway
Code added date: 20250101.
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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M1424 - Pulmonology care mvp
Long description: Pulmonology care mips value pathway
Code added date: 20250101.
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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M1425 - Surgical care mvp
Long description: Surgical care mips value pathway
Code added date: 20250101.
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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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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