HCPCS Level II › M

HCPCS Level II codes starting with M

506 codes, page 2 of 6. Every code ever valid for billing is listed, including those now retired.

CodeDescriptionStatus
M1063 Patients receiving high doses of immunosuppressive therapy through FY2026 Terminated
M1064 Shingrix vaccine documented as administered or previously received through FY2026 Terminated
M1065 Shingrix vaccine was not administered for reasons documented by clinician (e.g. patient administered vaccine other than shingrix, patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) through FY2026 Terminated
M1066 Shingrix vaccine not documented as administered, reason not given through FY2026 Terminated
M1067 Hospice services for patient provided any time during the measurement period Valid
M1068 Adults who are not ambulatory Valid
M1069 Patient screened for future fall risk Valid
M1070 Patient not screened for future fall risk, reason not given Valid
M1071 Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy through FY2026 Terminated
M1106 The start of an episode of care documented in the medical record Valid
M1107 Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care Valid
M1108 Ongoing care not clinically indicated because the patient needed a home program only, referral to another provider or facility, or consultation only, as documented in the medical record Valid
M1109 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 Valid
M1110 Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown) Valid
M1111 The start of an episode of care documented in the medical record Valid
M1112 Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care Valid
M1113 Ongoing care not clinically indicated because the patient needed a home program only, referral to another provider or facility, or consultation only, as documented in the medical record Valid
M1114 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 Valid
M1115 Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown) Valid
M1116 The start of an episode of care documented in the medical record Valid
M1117 Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care Valid
M1118 Ongoing care not clinically indicated because the patient needed a home program only, referral to another provider or facility, or consultation only, as documented in the medical record Valid
M1119 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 Valid
M1120 Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown) Valid
M1121 The start of an episode of care documented in the medical record Valid
M1122 Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care Valid
M1123 Ongoing care not clinically indicated because the patient needed a home program only, referral to another provider or facility, or consultation only, as documented in the medical record Valid
M1124 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 Valid
M1125 Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown) Valid
M1126 The start of an episode of care documented in the medical record Valid
M1127 Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care Valid
M1128 Ongoing care not clinically indicated because the patient needed a home program only, referral to another provider or facility, or consultation only, as documented in the medical record Valid
M1129 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 Valid
M1130 Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown) Valid
M1131 Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care Valid
M1132 Ongoing care not clinically indicated because the patient needed a home program only, referral to another provider or facility, or consultation only, as documented in the medical record Valid
M1133 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 Valid
M1134 Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown) Valid
M1135 The start of an episode of care documented in the medical record Valid
M1136 The start of an episode of care documented in the medical record through FY2026 Terminated
M1137 Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care through FY2026 Terminated
M1138 Ongoing care not indicated, patient seen only 1-2 visits (e.g., home program only, referred to another provider or facility, consultation only) through FY2026 Terminated
M1139 Ongoing care not indicated, patient self-discharged early and seen only 1-2 visits (e.g., financial or insurance reasons, transportation problems, or reason unknown) through FY2026 Terminated
M1140 Ongoing care not indicated, patient discharged after only 1-2 visits due to specific medical events, documented in the medical record that make the treatment episode impossible such as the patient becomes hospitalized or scheduled for surgery for surgery or hospitalized through FY2026 Terminated
M1141 Functional status was not measured by the oxford knee score (oks) or the knee injury and osteoarthritis outcome score joint replacement (koos, jr.) at one year (9 to 15 months) postoperatively Valid
M1142 Emergent cases Valid
M1143 Initiated episode of rehabilitation therapy, medical, or chiropractic care for neck impairment Valid
M1144 Ongoing care not indicated, patient seen only 1-2 visits (e.g., home program only, referred to another provider or facility, consultation only through FY2026 Terminated
M1145 Most favored nation (mfn) model drug add-on amount, per dose, (do not bill with line items that have the jw modifier) through FY2026 Terminated
M1146 Ongoing care not clinically indicated because the patient needed a home program only, referral to another provider or facility, or consultation only, as documented in the medical record Valid
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 Valid
M1148 Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown) Valid
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 Valid
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 Valid
M1151 Patients with a history of heart transplant or with a left ventricular assist device (lvad) Valid
M1152 Patients with a history of heart transplant or with a left ventricular assist device (lvad) Valid
M1153 Patient with diagnosis of osteoporosis on date of encounter Valid
M1154 Hospice services provided to patient any time during the measurement period through FY2026 Terminated
M1155 Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period through FY2026 Terminated
M1156 Patient received active chemotherapy any time during the measurement period through FY2026 Terminated
M1157 Patient received bone marrow transplant any time during the measurement period through FY2026 Terminated
M1158 Patient had history of immunocompromising conditions prior to or during the measurement period through FY2026 Terminated
M1159 Hospice services provided to patient any time during the measurement period Valid
M1160 Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patient's 13th birthday Valid
M1161 Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patient's 13th birthday Valid
M1162 Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patient's 13th birthday Valid
M1163 Patient had anaphylaxis due to the hpv vaccine any time on or before the patient's 13th birthday Valid
M1164 Patients with dementia any time during the patient's history through the end of the measurement period Valid
M1165 Patients who use hospice services any time during the measurement period Valid
M1166 Pathology report for tissue specimens produced from wide local excisions or re-excisions Valid
M1167 In hospice or using hospice services during the measurement period Valid
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 Valid
M1169 Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine) Valid
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 Valid
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 Valid
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) Valid
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 Valid
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 Valid
M1175 Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine) Valid
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 Valid
M1177 Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period Valid
M1178 Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine) Valid
M1179 Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period Valid
M1180 Patients on immune checkpoint inhibitor therapy Valid
M1181 Grade 2 or above diarrhea and/or grade 2 or above colitis Valid
M1182 Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohn's disease) Valid
M1183 Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered Valid
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) Valid
M1185 Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given Valid
M1186 Patients who have an order for or are receiving hospice or palliative care Valid
M1187 Patients with a diagnosis of end stage renal disease (esrd) Valid
M1188 Patients with a diagnosis of chronic kidney disease (ckd) stage 5 Valid
M1189 Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed Valid
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) Valid
M1191 Hospice services provided to patient any time during the measurement period Valid
M1192 Patients with an existing diagnosis of squamous cell carcinoma of the esophagus Valid
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 Valid
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) Valid
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 Valid
M1196 Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4 Valid
Page 2 of 6