HCPCS Level II › M
HCPCS Level II codes starting with M
506 codes, page 3 of 6. Every code ever valid for billing is listed, including those now retired.
| Code | Description | Status |
|---|---|---|
| M1197 | Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score | Valid |
| M1198 | 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 | Valid |
| M1199 | Patients receiving rrt | Valid |
| M1200 | Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period | Valid |
| 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) | Valid |
| 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) | Valid |
| M1203 | Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given | Valid |
| M1204 | Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4 | Valid |
| M1205 | Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score | Valid |
| 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 | Valid |
| M1207 | Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety | Valid |
| M1208 | Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety | Valid |
| M1209 | At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses | Valid |
| M1210 | At least two orders for high-risk medications from the same drug class, (table 4), not ordered | Valid |
| M1211 | Most recent glycemic status assessment (hba1c or gmi) level > 9.0% | Valid |
| M1212 | Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period | Valid |
| M1213 | No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70% | Valid |
| M1214 | Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed | Valid |
| M1215 | Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy) | Valid |
| M1216 | No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter | Valid |
| 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) | Valid |
| M1218 | Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing) | Valid |
| M1219 | Anaphylaxis due to the vaccine on or before the date of the encounter through FY2026 | Terminated |
| M1220 | Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy | Valid |
| M1221 | Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy | Valid |
| M1222 | Glaucoma plan of care not documented, reason not otherwise specified | Valid |
| M1223 | Glaucoma plan of care documented | Valid |
| M1224 | Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level | Valid |
| M1225 | Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level | Valid |
| M1226 | Iop measurement not documented, reason not otherwise specified | Valid |
| M1227 | Evidence-based therapy was prescribed | Valid |
| 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 | Valid |
| 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 | Valid |
| 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 | Valid |
| M1231 | Patient receives hcv antibody test with nonreactive result | Valid |
| M1232 | Patient receives hcv antibody test with reactive result | Valid |
| M1233 | Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given | Valid |
| M1234 | Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia | Valid |
| M1235 | Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period | Valid |
| M1236 | Baseline mrs > 2 | Valid |
| 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) | Valid |
| 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) | Valid |
| M1239 | Patient did not respond to the question of patient felt heard and understood by this provider and team | Valid |
| 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 | Valid |
| 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 | Valid |
| M1242 | Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life | Valid |
| M1243 | Patient provided a response other than "completely true" for the question of patient felt heard and understood by this provider and team | Valid |
| 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 | Valid |
| 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 | Valid |
| 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 | Valid |
| 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 | Valid |
| 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 | Valid |
| M1249 | Patient responded "completely true" for the question of patient felt this provider and team understood what is important to me in my life | Valid |
| M1250 | Patient responded as "completely true" for the question of patient felt heard and understood by this provider and team | Valid |
| M1251 | Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement) | Valid |
| 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 | Valid |
| 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) | Valid |
| M1254 | Patients who were deceased when the hu survey reached them | Valid |
| 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) | Valid |
| M1256 | Prior history of known cvd | Valid |
| M1257 | Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified | Valid |
| M1258 | Cvd risk assessment performed, have a documented calculated risk score | Valid |
| M1259 | Patient status documented within the first year of initiating dialysis | Valid |
| M1260 | Patient status not documented within the first year of initiating dialysis | Valid |
| M1261 | Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis | Valid |
| M1262 | Patients who had a transplant prior to initiation of dialysis | Valid |
| M1263 | Patients in hospice on their initiation of dialysis date or during the month of evaluation | Valid |
| M1264 | Patients age 75 or older on their initiation of dialysis date through FY2026 | Terminated |
| M1265 | Cms medical evidence form 2728 for dialysis patients: initial form completed | Valid |
| M1266 | Patients admitted to a skilled nursing facility (snf) | Valid |
| 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 | Valid |
| 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 | Valid |
| M1269 | Receiving esrd mcp dialysis services by the provider on the last day of the reporting month | Valid |
| M1270 | Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period | Valid |
| M1271 | Patients with dementia at any time prior to or during the month | Valid |
| M1272 | Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period | Valid |
| M1273 | Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form | Valid |
| M1274 | Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month | Valid |
| M1275 | Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period | Valid |
| M1276 | Bmi documented outside normal parameters, no follow-up plan documented, no reason given | Valid |
| M1277 | Colorectal cancer screening results documented and reviewed | Valid |
| M1278 | Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented | Valid |
| M1279 | Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given | Valid |
| 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 | Valid |
| M1281 | Blood pressure reading not documented, reason not given | Valid |
| M1282 | Patient screened for tobacco use and identified as a tobacco non-user | Valid |
| M1283 | Patient screened for tobacco use and identified as a tobacco user | Valid |
| 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 | Valid |
| M1285 | Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified | Valid |
| M1286 | Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason | Valid |
| M1287 | Bmi is documented below normal parameters and a follow-up plan is documented | Valid |
| M1288 | Documented reason for not screening or recommending a follow-up for high blood pressure | Valid |
| 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) | Valid |
| M1290 | Patient not eligible due to active diagnosis of hypertension | Valid |
| 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 | Valid |
| 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 | Valid |
| M1293 | Bmi is documented above normal parameters and a follow-up plan is documented | Valid |
| M1294 | Normal blood pressure reading documented, follow-up not required | Valid |
| M1295 | Patients with a diagnosis or past history of total colectomy or colorectal cancer | Valid |
| M1296 | Bmi is documented within normal parameters and no follow-up plan is required | Valid |