HCPCS Service Codes - Medical care

HCPCS Codes for Medical care

• 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

• 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

• 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