Showing codes M1407 (Patients who died during the follow-up period) — M1437 (Encounters conducted via telehealth)

M1407 - Pt died dur perf pd
Long description: Patients who died during the follow-up 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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M1408 - Gmln brca bef dx ca
Long description: Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer
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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M1409 - Recd gmln brca1/brca2 couns
Long description: Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis
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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M1410 - No gmln brca1/brca2 couns
Long description: Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis
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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M1411 - 1st ln ici no chemo
Long description: Currently on first-line immune checkpoint inhibitors without chemotherapy
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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M1412 - Met nsclc w/ egfr alk oth ab
Long description: Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skipping mutation, and ret rearrangement
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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M1413 - Pos pdl1 bef init ici tx
Long description: Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy
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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M1414 - Med rsn no pdl1 bef 1st ther
Long description: Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patient's health status; other medical reasons/contraindication)
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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M1415 - No pos pdl1 bef ici ther
Long description: Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy
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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M1416 - Pt rec hosp
Long description: Patient received hospice services any time 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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M1417 - Pt up to date cov
Long description: Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination
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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M1418 - Med rsn not up to date cov
Long description: Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by clinician
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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M1419 - Pt not up to date cov
Long description: Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination
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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M1420 - Complete ophthalmologic mvp
Long description: Complete ophthalmologic care mips value pathway
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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M1421 - Dermatological care mvp
Long description: Dermatological care mips value pathway
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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M1422 - Gastroenterology care mvp
Long description: Gastroenterology care mips value pathway
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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M1423 - Opt care urologic cnd mvp
Long description: Optimal care for patients with urologic conditions mips value pathway
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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M1424 - Pulmonology care mvp
Long description: Pulmonology care mips value pathway
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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M1425 - Surgical care mvp
Long description: Surgical care mips value pathway
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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M1426 - Telehealth enc
Long description: Encounters conducted via telehealth
Code added date: 20260101.
Code effective date: 20260101.
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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M1427 - Doc med rsn bone scn
Long description: Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)
Code added date: 20260101.
Code effective date: 20260101.
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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M1428 - Bilateral absence of eyes
Long description: Patients who have bilateral absence of eyes any time during the patient's history through the end of the measurement period
Code added date: 20260101.
Code effective date: 20260101.
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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M1429 - Retinopathy in od, os, ou
Long description: Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented
Code added date: 20260101.
Code effective date: 20260101.
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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M1430 - Ret exm ou no retinopthy doc
Long description: Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)
Code added date: 20260101.
Code effective date: 20260101.
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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M1431 - Telehealth enc
Long description: Encounters conducted via telehealth
Code added date: 20260101.
Code effective date: 20260101.
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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M1432 - Telehealth enc
Long description: Encounters conducted via telehealth
Code added date: 20260101.
Code effective date: 20260101.
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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M1433 - Oral chemo wthn 30 days enc
Long description: Patient on oral chemotherapy on or within 30 days before denominator eligible encounter
Code added date: 20260101.
Code effective date: 20260101.
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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M1434 - Orl chemo wthn 30 d post enc
Long description: Patient on oral chemotherapy on or within 30 days after denominator eligible encounter
Code added date: 20260101.
Code effective date: 20260101.
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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M1435 - Oral chemo in perf pd
Long description: Patient on oral chemotherapy during the performance period
Code added date: 20260101.
Code effective date: 20260101.
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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M1436 - Telehealth enc
Long description: Encounters conducted via telehealth
Code added date: 20260101.
Code effective date: 20260101.
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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M1437 - Telehealth enc
Long description: Encounters conducted via telehealth
Code added date: 20260101.
Code effective date: 20260101.
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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