Showing codes M1351 (Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation) — 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)
M1351 - Pt cmplt suicd saf pln 120dy
Long description: Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation
Code added date: 20240101.
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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M1352 - Suicd c-ssrs assessment, equ
Long description: Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment
Code added date: 20240101.
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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M1353 - Pts no cmplt suicd saf pln
Long description: Patients who did not have a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter
Code added date: 20240101.
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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M1354 - Pt no suicd saf pln 120dy
Long description: Patients who did not have a suicide safety plan initiated, reviewed, or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation
Code added date: 20240101.
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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M1355 - Suicd based cln eval
Long description: Suicide risk based on their clinician's evaluation or a clinician-rated tool
Code added date: 20240101.
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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M1356 - Pt died dur meas pd
Long description: Patients who died during the measurement period
Code added date: 20240101.
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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M1357 - Pt w/red suic idea 120 days
Long description: Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment
Code added date: 20240101.
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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M1359 - Indx suicd idea, no 0 scr
Long description: Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained
Code added date: 20240101.
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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M1360 - Suicd c-ssrs assessment
Long description: Suicidal ideation and/or behavior symptoms based on the c-ssrs
Code added date: 20240101.
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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M1361 - Suicd based cln eval
Long description: Suicide risk based on their clinician's evaluation or a clinician-rated tool
Code added date: 20240101.
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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M1362 - Pt died dur meas pd
Long description: Patients who died during the measurement period
Code added date: 20240101.
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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M1363 - Pts no f/u 120 dys
Long description: Patients who did not have a follow-up assessment within 120 days of the index assessment
Code added date: 20240101.
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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M1364 - Ascvd risk >=20pct
Long description: Calculated 10-year ascvd risk score of >= 20 percent during the performance period
Code added date: 20240101.
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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M1365 - Hosp+pall care spec code 17
Long description: Patient encounter during the performance period with hospice and palliative care specialty code 17
Code added date: 20240101.
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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M1366 - Focus on women's health mvp
Long description: Focusing on women's health mips value pathway
Code added date: 20240101.
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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M1367 - Qual care ent disorder mvp
Long description: Quality care for the treatment of ear, nose, and throat disorders mips value pathway
Code added date: 20240101.
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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M1368 - Prev trt inf d/o hiv/hep mvp
Long description: Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway
Code added date: 20240101.
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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M1369 - Qualcare mental hlth/sud mvp
Long description: Quality care in mental health and substance use disorders mips value pathway
Code added date: 20240101.
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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M1370 - Rehab support msk care mvp
Long description: Rehabilitative support for musculoskeletal care mips value pathway
Code added date: 20240101.
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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M1371 - Mst rec gsa<7
Long description: Most recent glycemic status assessment (hba1c or gmi) level < 7.0%
Code added date: 20250101.
Code effective date: 20250101.
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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M1372 - Mst rec gsa >=7 and<8
Long description: Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%
Code added date: 20250101.
Code effective date: 20250101.
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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M1373 - Mst rec gsa >=8 and <=9
Long description: Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%
Code added date: 20250101.
Code effective date: 20250101.
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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M1374 - Ra dx enc 90 days dur per pd
Long description: 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
Code added date: 20250101.
Code effective date: 20250101.
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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M1375 - Ra dx enc 90 days dur per pd
Long description: 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
Code added date: 20250101.
Code effective date: 20250101.
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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M1376 - Ra dx enc 90 days dur per pd
Long description: 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
Code added date: 20250101.
Code effective date: 20250101.
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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M1377 - Fu colscop 10 yr doc w/ disc
Long description: Recommended follow-up interval for repeat colonoscopy of 10 years documented in colonoscopy report and communicated with patient
Code added date: 20250101.
Code effective date: 20250101.
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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M1378 - Med rsn no 10 yr fu colscope
Long description: 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)
Code added date: 20250101.
Code effective date: 20250101.
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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M1379 - 10 yr fu no rec rsn not giv
Long description: A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified
Code added date: 20250101.
Code effective date: 20250101.
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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M1380 - 2 rx in perf pd any com meds
Code added date: 20250101.
Code effective date: 20250101.
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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M1381 - Pt sec strk wthin 5 days
Long description: 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
Code added date: 20250101.
Code effective date: 20250101.
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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PDF