HCPCS Service Codes - Medical care

HCPCS Codes for Medical care

• M1369

  Quality care in mental health and substance use disorders mips value pathway

• M1370

  Rehabilitative support for musculoskeletal care mips value pathway

• M1371

  Most recent glycemic status assessment (hba1c or gmi) level < 7.0%

• M1372

  Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%

• M1373

  Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%

• M1374

  An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period

• M1375

  An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period

• M1376

  An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period

• M1377

  Recommended follow-up interval for repeat colonoscopy of 10 years documented in colonoscopy report and communicated with patient

• M1378

  Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)

• M1379

  A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified

• M1380

  Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under "denominator note" or the long-acting injectable antipsychotic medications listed under "denominator note"

• M1381

  Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure

• M1382

  Patient encounter during the performance period with place of service code 11

• M1383

  Acute pvd

• M1384

  Patients who died during the performance period

• M1385

  Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up

• M1386

  Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period

• M1387

  Patients who died during the performance period

• M1388

  Patients with documentation of an exam performed for recurrence of melanoma

• M1390

  Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period

• M1391

  All patients who were diagnosed with recurrent melanoma during the current performance period

• M1392

  Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by phone, mail or secure electronic mail - at least one method must be documented)

• M1393

  Patients who were not diagnosed with recurrent melanoma during the current performance period

• M1394

  Stages i-iii breast cancer

• M1395

  Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group

• M1396

  Patients on a therapeutic clinical trial

• M1397

  Patients with recurrence/disease progression

• M1398

  Patients with baseline and follow-up promis surveys documented in the medical record

• M1399

  Patients who leave the practice during the follow-up period

• M1400

  Patients who died during the follow-up period

• M1401

  Stages i-iii breast cancer

• M1402

  Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group

• M1403

  Patients with baseline and follow-up promis surveys documented in the medical record

• M1404

  Patients on a therapeutic clinical trial

• M1405

  Patients with recurrence/disease progression

• M1406

  Patients who leave the practice during the follow-up period

• M1407

  Patients who died during the follow-up period

• M1408

  Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer

• M1409

  Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis

• M1410

  Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis

• M1411

  Currently on first-line immune checkpoint inhibitors without chemotherapy

• M1412

  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

• M1413

  Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy

• M1414

  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)

• M1415

  Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy

• M1416

  Patient received hospice services any time during the performance period

• M1417

  Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination

• M1418

  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

• M1419

  Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination