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• M1147

  Ongoing care not medically possible because the patient was discharged early due to specific medical events, documented in the medical record, such as the patient became hospitalized or scheduled for surgery

• M1148

  Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)

• M1149

  Patient unable to complete the neck fs prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility, and an adequate proxy is not available

• M1150

  Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function

• M1151

  Patients with a history of heart transplant or with a left ventricular assist device (lvad)

• M1152

  Patients with a history of heart transplant or with a left ventricular assist device (lvad)

• M1153

  Patient with diagnosis of osteoporosis on date of encounter

• M1154

  Hospice services provided to patient any time during the measurement period

• M1155

  Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period

• M1156

  Patient received active chemotherapy any time during the measurement period

• M1157

  Patient received bone marrow transplant any time during the measurement period

• M1158

  Patient had history of immunocompromising conditions prior to or during the measurement period

• M1159

  Hospice services provided to patient any time during the measurement period

• M1160

  Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patient's 13th birthday

• M1161

  Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patient's 13th birthday

• M1162

  Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patient's 13th birthday

• M1163

  Patient had anaphylaxis due to the hpv vaccine any time on or before the patient's 13th birthday

• M1164

  Patients with dementia any time during the patient's history through the end of the measurement period

• M1165

  Patients who use hospice services any time during the measurement period

• M1166

  Pathology report for tissue specimens produced from wide local excisions or re-excisions

• M1167

  In hospice or using hospice services during the measurement period

• M1168

  Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period

• M1169

  Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)

• M1170

  Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period

• M1171

  Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period

• M1172

  Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine)

• M1173

  Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period

• M1174

  Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period

• M1175

  Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)

• M1176

  Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period

• M1177

  Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period

• M1178

  Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)

• M1179

  Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period

• M1180

  Patients on immune checkpoint inhibitor therapy

• M1181

  Grade 2 or above diarrhea and/or grade 2 or above colitis

• M1182

  Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohn's disease)

• M1183

  Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered

• M1184

  Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting diagnostic workup results for alternative etiologies, other medical reasons/contraindication)

• M1185

  Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given

• M1186

  Patients who have an order for or are receiving hospice or palliative care

• M1187

  Patients with a diagnosis of end stage renal disease (esrd)

• M1188

  Patients with a diagnosis of chronic kidney disease (ckd) stage 5

• M1189

  Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed

• M1190

  Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)

• M1191

  Hospice services provided to patient any time during the measurement period

• M1192

  Patients with an existing diagnosis of squamous cell carcinoma of the esophagus

• M1193

  Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both

• M1194

  Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therapy, no residual carcinoma is present in the sample [tissue exhausted or status post neoadjuvant treatment], insufficient tumor for testing)

• M1195

  Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given

• M1196

  Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4

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HCPCS Level II codes and descriptors are approved and maintained jointly by the alpha-numeric editorial panel (consisting of CMS, the Health Insurance Association of America, and the Blue Cross and Blue Shield Association). — Updated 7/21/2026

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