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HCPCS 2023 Codes
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M Codes
M Codes
Medical Services
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Codes
m0064
Brief office visit for the sole purpose of monitoring or changing drug prescriptions used in the treatment of mental psychoneurotic and personality disorders
m0075
Cellular therapy
m0076
Prolotherapy
m0100
Intragastric hypothermia using gastric freezing
m0201
Covid-19 vaccine administration inside a patient's home; reported only once per individual home per date of service when only covid-19 vaccine administration is performed at the patient's home
m0239
Intravenous infusion, bamlanivimab-xxxx, includes infusion and post administration monitoring
m0240
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring, subsequent repeat doses
m0241
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring in the home or residence; this includes a beneficiary's home that has been made provider-based to the hospital during the covid-19 public health emergency, subsequent repeat doses
m0243
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring
m0244
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring in the home or residence; this includes a beneficiary's home that has been made provider-based to the hospital during the covid-19 public health emergency
m0245
Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring
m0246
Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring in the home or residence; this includes a beneficiary's home that has been made provider based to the hospital during the covid 19 public health emergency
m0247
Intravenous infusion, sotrovimab, includes infusion and post administration monitoring
m0248
Intravenous infusion, sotrovimab, includes infusion and post administration monitoring in the home or residence; this includes a beneficiary's home that has been made provider-based to the hospital during the covid-19 public health emergency
m0249
Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administration monitoring, first dose
m0250
Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administration monitoring, second dose
m0300
Iv chelation therapy (chemical endarterectomy)
m0301
Fabric wrapping of abdominal aneurysm
m1000
Pain screened as moderate to severe
m1001
Plan of care to address moderate to severe pain documented on or before the date of the second visit with a clinician
m1002
Plan of care for moderate to severe pain not documented on or before the date of the second visit with a clinician, reason not given
m1003
Tb screening performed and results interpreted within twelve months prior to initiation of first-time biologic disease modifying anti-rheumatic drug therapy
m1004
Documentation of medical reason for not screening for tb or interpreting results (i.e., patient positive for tb and documentation of past treatment; patient who has recently completed a course of anti-tb therapy)
m1005
Tb screening not performed or results not interpreted, reason not given
m1006
Disease activity not assessed, reason not given
m1007
>=50% of total number of a patient's outpatient ra encounters assessed
m1008
<50% of total number of a patient's outpatient ra encounters assessed
m1009
Discharge/discontinuation of the episode of care documented in the medical record
m1010
Discharge/discontinuation of the episode of care documented in the medical record
m1011
Discharge/discontinuation of the episode of care documented in the medical record
m1012
Discharge/discontinuation of the episode of care documented in the medical record
m1013
Discharge/discontinuation of the episode of care documented in the medical record
m1014
Discharge/discontinuation of the episode of care documented in the medical record
m1015
Discharge/discontinuation of the episode of care documented in the medical record
m1016
Female patients unable to bear children
m1017
Patient admitted to palliative care services
m1018
Patients with an active diagnosis or history of cancer (except basal cell and squamous cell skin carcinoma), patients who are heavy tobacco smokers, lung cancer screening patients
m1019
Adolescent patients 12 to 17 years of age with major depression or dysthymia who reached remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5
m1020
Adolescent patients 12 to 17 years of age with major depression or dysthymia who did not reach remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5. either phq-9 or phq-9m score was not assessed or is greater than or equal to 5
m1021
Patient had only urgent care visits during the performance period
m1022
Patients who were in hospice at any time during the performance period
m1023
Adolescent patients 12 to 17 years of age with major depression or dysthymia who reached remission at six months as demonstrated by a six month (+/-60 days) phq-9 or phq-9m score of less than five
m1024
Adolescent patients 12 to 17 years of age with major depression or dysthymia who did not reach remission at six months as demonstrated by a six month (+/-60 days) phq-9 or phq-9m score of less than five. either phq-9 or phq-9m score was not assessed or is greater than or equal to five
m1025
Patients who were in hospice at any time during the performance period
m1026
Patients who were in hospice at any time during the performance period
m1027
Imaging of the head (ct or mri) was obtained
m1028
Documentation of patients with primary headache diagnosis and imaging other than ct or mri obtained
m1029
Imaging of the head (ct or mri) was not obtained, reason not given
m1030
Patients with clinical indications for imaging of the head
m1031
Patients with no clinical indications for imaging of the head
m1032
Adults currently taking pharmacotherapy for oud
m1033
Pharmacotherapy for oud initiated after june 30th of performance period
m1034
Adults who have at least 180 days of continuous pharmacotherapy with a medication prescribed for oud without a gap of more than seven days
m1035
Adults who are deliberately phased out of medication assisted treatment (mat) prior to 180 days of continuous treatment
m1036
Adults who have not had at least 180 days of continuous pharmacotherapy with a medication prescribed for oud without a gap of more than seven days
m1037
Patients with a diagnosis of lumbar spine region cancer at the time of the procedure
m1038
Patients with a diagnosis of lumbar spine region fracture at the time of the procedure
m1039
Patients with a diagnosis of lumbar spine region infection at the time of the procedure
m1040
Patients with a diagnosis of lumbar idiopathic or congenital scoliosis
m1041
Patient had cancer, acute fracture or infection related to the lumbar spine or patient had neuromuscular, idiopathic or congenital lumbar scoliosis
m1042
Functional status measurement with score was obtained utilizing the oswestry disability index (odi version 2.1a) patient reported outcome tool within three months preoperatively and at one year (9 to 15 months) postoperatively
m1043
Functional status was not measured by the oswestry disability index (odi version 2.1a) at one year (9 to 15 months) postoperatively
m1044
Functional status was measured by the oswestry disability index (odi version 2.1a) patient reported outcome tool within three months preoperatively and at one year (9 to 15 months) postoperatively
m1045
Functional status measured by the oxford knee score (oks) at one year (9 to 15 months) postoperatively was greater than or equal to 37 or knee injury and osteoarthritis outcome score joint replacement (koos, jr.) was greater than or equal to 71
m1046
Functional status measured by the oxford knee score (oks) at one year (9 to 15 months) postoperatively was less than 37 or the knee injury and osteoarthritis outcome score joint replacement (koos, jr.) was less than 71 postoperatively
m1047
Functional status was measured by the oxford knee score (oks) patient reported outcome tool within three months preoperatively and at one year (9 to 15 months) postoperatively
m1048
Functional status measurement with score was obtained utilizing the oswestry disability index (odi version 2.1a) patient reported outcome tool within three months preoperatively and at three months (6 to 20 weeks) postoperatively
m1049
Functional status was not measured by the oswestry disability index (odi version 2.1a) at three months (6 - 20 weeks) postoperatively
m1050
Functional status was measured by the oswestry disability index (odi version 2.1a) patient reported outcome tool within three months preoperatively and at three months (6 to 20 weeks) postoperatively
m1051
Patient had cancer, acute fracture or infection related to the lumbar spine or patient had neuromuscular, idiopathic or congenital lumbar scoliosis
m1052
Leg pain was not measured by the visual analog scale (vas) at one year (9 to 15 months) postoperatively
m1053
Leg pain was measured by the visual analog scale (vas) within three months preoperatively and at one year (9 to 15 months) postoperatively
m1054
Patient had only urgent care visits during the performance period
m1055
Aspirin or another antiplatelet therapy used
m1056
Prescribed anticoagulant medication during the performance period, history of gi bleeding, history of intracranial bleeding, bleeding disorder and specific provider documented reasons: allergy to aspirin or anti-platelets, use of non-steroidal anti-inflammatory agents, drug-drug interaction, uncontrolled hypertension > 180/110 mmhg or gastroesophageal reflux disease
m1057
Aspirin or another antiplatelet therapy not used, reason not given
m1058
Patient was a permanent nursing home resident at any time during the performance period
m1059
Patient was in hospice or receiving palliative care at any time during the performance period
m1060
Patient died prior to the end of the performance period
m1061
Patient pregnancy
m1062
Patient immunocompromised
m1063
Patients receiving high doses of immunosuppressive therapy
m1064
Shingrix vaccine documented as administered or previously received
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)
m1066
Shingrix vaccine not documented as administered, reason not given
m1067
Hospice services for patient provided any time during the measurement period
m1068
Adults who are not ambulatory
m1069
Patient screened for future fall risk
m1070
Patient not screened for future fall risk, reason not given
m1071
Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy
m1106
The start of an episode of care documented in the medical record
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
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
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
m1110
Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)
m1111
The start of an episode of care documented in the medical record
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
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
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
m1115
Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)
m1116
The start of an episode of care documented in the medical record
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
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
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
m1120
Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)
m1121
The start of an episode of care documented in the medical record
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
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
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
m1125
Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)
m1126
The start of an episode of care documented in the medical record
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
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
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
m1130
Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)
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
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
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
m1134
Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)
m1135
The start of an episode of care documented in the medical record
m1136
The start of an episode of care documented in the medical record
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
m1138
Ongoing care not indicated, patient seen only 1-2 visits (e.g., home program only, referred to another provider or facility, consultation only)
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)
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
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
m1142
Emergent cases
m1143
Initiated episode of rehabilitation therapy, medical, or chiropractic care for neck impairment
m1144
Ongoing care not indicated, patient seen only 1-2 visits (e.g., home program only, referred to another provider or facility, consultation only
m1145
Most favored nation (mfn) model drug add-on amount, per dose, (do not bill with line items that have the jw modifier)
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
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
m1148
Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)
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
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