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• M1199

  Patients receiving rrt

• M1200

  Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period

• M1201

  Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other allergy to ace-i and arb, hyperkalemia or history of hyperkalemia while on ace-i or arb therapy, acute kidney injury due to ace-i or arb therapy), other medical reasons)

• M1202

  Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)

• M1203

  Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given

• M1204

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

• M1205

  Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score

• M1206

  Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter

• M1207

  Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety

• M1208

  Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety

• M1209

  At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses

• M1210

  At least two orders for high-risk medications from the same drug class, (table 4), not ordered

• M1211

  Most recent glycemic status assessment (hba1c or gmi) level > 9.0%

• M1212

  Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period

• M1213

  No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%

• M1214

  Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed

• M1215

  Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)

• M1216

  No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter

• M1217

  Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)

• M1218

  Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)

• M1219

  Anaphylaxis due to the vaccine on or before the date of the encounter

• M1220

  Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy

• M1221

  Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy

• M1222

  Glaucoma plan of care not documented, reason not otherwise specified

• M1223

  Glaucoma plan of care documented

• M1224

  Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level

• M1225

  Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level

• M1226

  Iop measurement not documented, reason not otherwise specified

• M1227

  Evidence-based therapy was prescribed

• M1228

  Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test

• M1229

  Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection

• M1230

  Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment initiated within 3 months of the reactive hcv antibody test, reason not given

• M1231

  Patient receives hcv antibody test with nonreactive result

• M1232

  Patient receives hcv antibody test with reactive result

• M1233

  Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given

• M1234

  Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia

• M1235

  Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period

• M1236

  Baseline mrs > 2

• M1237

  Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)

• M1238

  Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)

• M1239

  Patient did not respond to the question of patient felt heard and understood by this provider and team

• M1240

  Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care

• M1241

  Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem

• M1242

  Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life

• M1243

  Patient provided a response other than "completely true" for the question of patient felt heard and understood by this provider and team

• M1244

  Patient provided a response other than "completely true" for the question of patient felt this provider and team put my best interests first when making recommendations about my care

• M1245

  Patient provided a response other than "completely true" for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem

• M1246

  Patient provided a response other than "completely true" for the question of patient felt this provider and team understood what is important to me in my life

• M1247

  Patient responded "completely true" for the question of patient felt this provider and team put my best interests first when making recommendations about my care

• M1248

  Patient responded "completely true" for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem

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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 6/3/2026

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