Showing codes 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) — 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)

M1140 - Oc ni pt dc 1-2 vis
Long description: 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
Code added date: 20200101.
Code effective date: 20210101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1141 - Fs no oks
Long description: 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
Code added date: 20200101.
Code effective date: 20210101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1142 - Emerge cases
Long description: Emergent cases
Code added date: 20200101.
Code effective date: 20200101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1143 - Ni rehab med chiro
Long description: Initiated episode of rehabilitation therapy, medical, or chiropractic care for neck impairment
Code added date: 20200101.
Code effective date: 20200101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1144 - Oc no ind pt 1-2 vis
Long description: Ongoing care not indicated, patient seen only 1-2 visits (e.g., home program only, referred to another provider or facility, consultation only
Code added date: 20200101.
Code effective date: 20210101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1145 - Mfn drug add-on, per dose
Long description: Most favored nation (mfn) model drug add-on amount, per dose, (do not bill with line items that have the jw modifier)
Code added date: 20210101.
Code effective date: 20220228.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1146 - Ongoing care not ind
Long description: 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
Code added date: 20210101.
Code effective date: 20210101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1147 - Care not poss med rsn
Long description: 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
Code added date: 20210101.
Code effective date: 20210101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1148 - Pt self dschg
Long description: Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)
Code added date: 20210101.
Code effective date: 20210101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1149 - No neck fs prom incap
Long description: 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
Code added date: 20210101.
Code effective date: 20210101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1150 - Lvef <=40% or mod/sev l vsf
Long description: Left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function
Code added date: 20230101.
Code effective date: 20230101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1151 - Pt w/ hx trnsplt or lvad
Long description: Patients with a history of heart transplant or with a left ventricular assist device (lvad)
Code added date: 20230101.
Code effective date: 20230101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1152 - Pt w/ hx trnsplt or lvad
Long description: Patients with a history of heart transplant or with a left ventricular assist device (lvad)
Code added date: 20230101.
Code effective date: 20230101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1153 - Pt w/ dx osteo doe
Long description: Patient with diagnosis of osteoporosis on date of encounter
Code added date: 20230101.
Code effective date: 20230101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1154 - Hospc serv dur meas pd
Long description: Hospice services provided to patient any time during the measurement period
Code added date: 20230101.
Code effective date: 20230101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1155 - Pt anphx due to pneum
Long description: Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period
Code added date: 20230101.
Code effective date: 20230101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1156 - Pt recd actv chemo any time
Long description: Patient received active chemotherapy any time during the measurement period
Code added date: 20230101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1157 - Pt recd bone mar trnsplt
Long description: Patient received bone marrow transplant any time during the measurement period
Code added date: 20230101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1158 - Pt hx immcomp prior/dur pd
Long description: Patient had history of immunocompromising conditions prior to or during the measurement period
Code added date: 20230101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1159 - Hospc serv dur meas pd
Long description: Hospice services provided to patient any time during the measurement period
Code added date: 20230101.
Code effective date: 20230101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1160 - Pt anphx due to mengb bef 13
Long description: Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patient's 13th birthday
Code added date: 20230101.
Code effective date: 20230101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1161 - Pt anphx due to dtp bef 13
Long description: Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patient's 13th birthday
Code added date: 20230101.
Code effective date: 20230101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1162 - Pt enceph due to dtp bef 13
Long description: Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patient's 13th birthday
Code added date: 20230101.
Code effective date: 20230101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1163 - Pt anphx due to hpv bef 13
Long description: Patient had anaphylaxis due to the hpv vaccine any time on or before the patient's 13th birthday
Code added date: 20230101.
Code effective date: 20230101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1164 - Pt w/ dementia any time
Long description: Patients with dementia any time during the patient's history through the end of the measurement period
Code added date: 20230101.
Code effective date: 20230101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1165 - Pt use hspc dur meas pd
Long description: Patients who use hospice services any time during the measurement period
Code added date: 20230101.
Code effective date: 20230101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1166 - Path rpt tis spec wle/reexc
Long description: Pathology report for tissue specimens produced from wide local excisions or re-excisions
Code added date: 20230101.
Code effective date: 20230101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1167 - Hspc dur meas pd
Long description: In hospice or using hospice services during the measurement period
Code added date: 20230101.
Code effective date: 20230101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1168 - Pt recd flu vax 7/1-6/30
Long description: 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
Code added date: 20230101.
Code effective date: 20230101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1169 - Doc med rsn no flu vax
Long description: Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)
Code added date: 20230101.
Code effective date: 20230101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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M1170 - Pt w/o flu vax 7/1-6/30
Long description: 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
Code added date: 20230101.
Code effective date: 20230101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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