HCPCS M-Codes
Medical services

  • M1249

    Patient responded "completely true" for the question of patient felt this provider and team understood what is important to me in my life

  • M1250

    Patient responded as "completely true" for the question of patient felt heard and understood by this provider and team

  • M1251

    Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)

  • M1252

    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

  • M1253

    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)

  • M1254

    Patients who were deceased when the hu survey reached them

  • M1255

    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)

  • M1256

    Prior history of known cvd

  • M1257

    Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified

  • M1258

    Cvd risk assessment performed, have a documented calculated risk score
  • Continued

  • M1259

    Patient status documented within the first year of initiating dialysis

  • M1260

    Patient status not documented within the first year of initiating dialysis

  • M1261

    Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis

  • M1262

    Patients who had a transplant prior to initiation of dialysis

  • M1263

    Patients in hospice on their initiation of dialysis date or during the month of evaluation

  • M1264

    Patients age 75 or older on their initiation of dialysis date

  • M1265

    Cms medical evidence form 2728 for dialysis patients: initial form completed

  • M1266

    Patients admitted to a skilled nursing facility (snf)

  • M1267

    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

  • M1268

    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

  • M1269

    Receiving esrd mcp dialysis services by the provider on the last day of the reporting month

  • M1270

    Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period

  • M1271

    Patients with dementia at any time prior to or during the month

  • M1272

    Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period

  • M1273

    Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form

  • M1274

    Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month

  • M1275

    Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period

  • M1276

    Bmi documented outside normal parameters, no follow-up plan documented, no reason given

  • M1277

    Colorectal cancer screening results documented and reviewed

  • M1278

    Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented
  • Continued

  • M1279

    Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given

  • M1280

    Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy

  • M1281

    Blood pressure reading not documented, reason not given

  • M1282

    Patient screened for tobacco use and identified as a tobacco non-user

  • M1283

    Patient screened for tobacco use and identified as a tobacco user

  • M1284

    Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period

  • M1285

    Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified

  • M1286

    Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason

  • M1287

    Bmi is documented below normal parameters and a follow-up plan is documented

  • M1288

    Documented reason for not screening or recommending a follow-up for high blood pressure

  • M1289

    Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)

  • M1290

    Patient not eligible due to active diagnosis of hypertension

  • M1291

    Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period

  • M1292

    Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period

  • M1293

    Bmi is documented above normal parameters and a follow-up plan is documented

  • M1294

    Normal blood pressure reading documented, follow-up not required

  • M1295

    Patients with a diagnosis or past history of total colectomy or colorectal cancer

  • M1296

    Bmi is documented within normal parameters and no follow-up plan is required

  • M1297

    Bmi not documented due to medical reason or patient refusal of height or weight measurement

  • M1298

    Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter