Medical Billing Code Search

9172 results found

M1062	Pt imcomprmd	Description: Patient immunocompromised
M1063	Pt rec hg dos imsup thpy	Description: Patients receiving high doses of immunosuppressive therapy
M1064	Shing vac doc adm or pv rec	Description: Shingrix vaccine documented as administered or previously received
M1065	Shing vac no adm clinc rsn	Description: 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	Shing vac no doc no rsn	Description: Shingrix vaccine not documented as administered, reason not given
M1067	Hspc pt prv time meam per	Description: Hospice services for patient provided any time during the measurement period
M1068	Pt not ambulatory	Description: Adults who are not ambulatory
M1069	Pt scr ft fall rsk	Description: Patient screened for future fall risk
M1070	Pt not scrn fut fall no rsn	Description: Patient not screened for future fall risk, reason not given
M1071	Pt had add'l sp pcr perf	Description: Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy
M1106	Start eoc doc med rec	Description: The start of an episode of care documented in the medical record
M1107	Docu dx degen neuro	Description: 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	Oc ni pt home prog	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
M1109	Oc ni pt dc	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
M1110	Oc not p pt selfdc	Description: Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)
M1111	Start eoc doc med rec	Description: The start of an episode of care documented in the medical record
M1112	Docu dx degen neuro	Description: 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	Oc ni pt home prog	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
M1114	Oc ni pt dc	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
M1115	Oc ni pt selfdc	Description: Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)
M1116	Start eoc doc med rec	Description: The start of an episode of care documented in the medical record
M1117	Docu dx degen neuro	Description: 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	Oc ni pt home prog	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
M1119	Oc ni pt dc	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
M1120	Oc ni pt selfdc	Description: Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)
M1121	Start eoc doc med rec	Description: The start of an episode of care documented in the medical record
M1122	Docu dx degen neuro	Description: 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	Oc ni pt home prog	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
M1124	Oc ni pt dc 1-2 vis	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
M1125	Oc ni pt selfdc 1-2 vis	Description: Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)
M1126	Start eoc doc med rec	Description: The start of an episode of care documented in the medical record
M1127	Docu dx degen neuro	Description: 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	Oc ni pt home prog	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
M1129	Oc ni pt dc	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
M1130	Oc ni pt selfdc	Description: Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)
M1131	Docu dx degen neuro	Description: 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	Oc ni pt home prog	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
M1133	Oc ni pt dc	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
M1134	Oc ni pt selfdc	Description: Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)
M1135	Start eoc doc med rec	Description: The start of an episode of care documented in the medical record
M1136	Start eoc doc med rec	Description: The start of an episode of care documented in the medical record
M1137	Docu dx degen neuro	Description: 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	Oc ni pt 1-2 vis	Description: Ongoing care not indicated, patient seen only 1-2 visits (e.g., home program only, referred to another provider or facility, consultation only)
M1139	Oc ni pt self dc 1-2 vis	Description: 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	Oc ni pt dc 1-2 vis	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
M1141	Fs no oks	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
M1142	Emerge cases	Description: Emergent cases
M1143	Ni rehab med chiro	Description: Initiated episode of rehabilitation therapy, medical, or chiropractic care for neck impairment
M1144	Oc no ind pt 1-2 vis	Description: Ongoing care not indicated, patient seen only 1-2 visits (e.g., home program only, referred to another provider or facility, consultation only
M1145	Mfn drug add-on, per dose	Description: 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 ind	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
M1147	Care not poss med rsn	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
M1148	Pt self dschg	Description: Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)
M1149	No neck fs prom incap	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
M1150	Lvef <=40% or mod/sev l vsf	Description: Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function
M1151	Pt w/ hx trnsplt or lvad	Description: Patients with a history of heart transplant or with a left ventricular assist device (lvad)
M1152	Pt w/ hx trnsplt or lvad	Description: Patients with a history of heart transplant or with a left ventricular assist device (lvad)
M1153	Pt w/ dx osteo doe	Description: Patient with diagnosis of osteoporosis on date of encounter
M1154	Hospc serv dur meas pd	Description: Hospice services provided to patient any time during the measurement period
M1155	Pt anphx due to pneum	Description: Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period
M1156	Pt recd actv chemo any time	Description: Patient received active chemotherapy any time during the measurement period
M1157	Pt recd bone mar trnsplt	Description: Patient received bone marrow transplant any time during the measurement period
M1158	Pt hx immcomp prior/dur pd	Description: Patient had history of immunocompromising conditions prior to or during the measurement period
M1159	Hospc serv dur meas pd	Description: Hospice services provided to patient any time during the measurement period
M1160	Pt anphx due to mengb bef 13	Description: Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patient's 13th birthday
M1161	Pt anphx due to dtp bef 13	Description: Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patient's 13th birthday
M1162	Pt enceph due to dtp bef 13	Description: Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patient's 13th birthday
M1163	Pt anphx due to hpv bef 13	Description: Patient had anaphylaxis due to the hpv vaccine any time on or before the patient's 13th birthday
M1164	Pt w/ dementia any time	Description: Patients with dementia any time during the patient's history through the end of the measurement period
M1165	Pt use hspc dur meas pd	Description: Patients who use hospice services any time during the measurement period
M1166	Path rpt tis spec wle/reexc	Description: Pathology report for tissue specimens produced from wide local excisions or re-excisions
M1167	Hspc dur meas pd	Description: In hospice or using hospice services during the measurement period
M1168	Pt recd flu vax 7/1-6/30	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
M1169	Doc med rsn no flu vax	Description: Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)
M1170	Pt w/o flu vax 7/1-6/30	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
M1171	Pt recd 1 td/tdap 9yrs prior	Description: Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period
M1172	Doc med rsn no td/tdap	Description: Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine)
M1173	Pt no rec td/tdap 9yrs prior	Description: Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period
M1175	Doc med rsn no hzv	Description: Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)
M1177	Pt recd pcv on/aft 19	Description: Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period
M1178	Doc med rsn no pcv	Description: Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)
M1179	No pcv recd	Description: Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period
M1180	Pt imm ckpt inhib therapy	Description: Patients on immune checkpoint inhibitor therapy
M1181	Gr 2 or> dia or gr2 or> col	Description: Grade 2 or above diarrhea and/or grade 2 or above colitis
M1182	Not elg pre ex ibd/uc/crohn	Description: Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohn's disease)
M1183	Doc imm ckpt inhib hld	Description: Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered
M1184	Doc med rsn no cst/ist rx	Description: Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting diagnostic workup results for alternative etiologies, other medical reasons/contraindication)
M1185	Imm ckpt inhib not hld no rx	Description: Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given
M1186	Pt w/ rx for hspc/plltv care	Description: Patients who have an order for or are receiving hospice or palliative care
M1187	Pt w/ esrd	Description: Patients with a diagnosis of end stage renal disease (esrd)
M1188	Pt w/ ckd stg 5	Description: Patients with a diagnosis of chronic kidney disease (ckd) stage 5
M1189	Doc khe pef w/efgr/uacr	Description: Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed
M1190	Doc khe not pef w/efgr/uacr	Description: Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)
M1191	Hspc svc any time in meas pd	Description: Hospice services provided to patient any time during the measurement period
M1192	Pt w/ dx sq cell ca of esoph	Description: Patients with an existing diagnosis of squamous cell carcinoma of the esophagus
M1193	Rpts w/ imp/con mmr/msi	Description: Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both
M1194	Med rsn no imp/con mmr/msi	Description: Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therapy, no residual carcinoma is present in the sample [tissue exhausted or status post neoadjuvant treatment], insufficient tumor for testing)
M1195	Rpt wo imp/con mmr/msi	Description: Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given
M1196	Ixv nrs vrs iqa >=4	Description: Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4
M1197	Isa reduced >=3 fr ixv	Description: Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score
M1198	Isa not red 3pts /no assess	Description: 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
M1199	Pt rec'g rrt	Description: Patients receiving rrt
M1200	Ace-i/arb rx	Description: Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period
M1201	Med rsn no ace-i/arb rx	Description: 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)
M1202	Pt rsn no ace-i/arb rx	Description: Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)
M1203	No rsn ace-i/arb rx	Description: Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given
M1204	Ixv nrs vrs iqa >=4	Description: Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4
M1205	Isa reduced >=3	Description: Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score
M1206	Isa not red 3pts/no assess	Description: 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
M1207	Pt scrn sdoh	Description: Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety
M1208	Pt no scrn sdoh	Description: Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety
M1209	>=2 same hi-rsk med w/o diag	Description: At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses
M1210	>=2 same meds tbl4 not ord	Description: At least two orders for high-risk medications from the same drug class, (table 4), not ordered
M1211	Gsa level>9.0%	Description: Most recent glycemic status assessment (hba1c or gmi) level > 9.0%
M1212	Missing gsa not perf	Description: Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period
M1213	No hx spiro prs spiro>=70%	Description: No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%
M1214	Spiro results wth obs doc	Description: Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed
M1215	Med rsn for no doc spiro	Description: Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)
M1216	No spiro doc no res doc	Description: No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter
M1217	Sys rsn no doc spiro	Description: Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)
M1218	Pt copd symptoms	Description: Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)
M1219	Anphx due to vax	Description: Anaphylaxis due to the vaccine on or before the date of the encounter
M1220	Dre wth interp rtnopthy	Description: Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy
M1221	Dre w/o rtnopthy	Description: Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy
M1222	Glaucoma pln of care not doc	Description: Glaucoma plan of care not documented, reason not otherwise specified
M1223	Glaucoma plan of care doc	Description: Glaucoma plan of care documented
M1224	Iop dec <20% from base	Description: Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level
M1225	Iop dec>=20% from base	Description: Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level
M1226	Iop not doc	Description: Iop measurement not documented, reason not otherwise specified
M1227	Eb therapy prescribed	Description: Evidence-based therapy was prescribed
M1228	Pt + hcv aby +vir w/ rx 3 mo	Description: 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
M1229	Pt w/ +hcv +vir ref win 1 mo	Description: 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
M1230	Pt hcv rctv aby no f/u tst	Description: 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
M1231	Pt hcv tst no reactive res	Description: Patient receives hcv antibody test with nonreactive result
M1232	Pt hcv tst reactive result	Description: Patient receives hcv antibody test with reactive result
M1233	Pt no hcv aby or result	Description: Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given
M1234	Pt hcv rctv aby f/u neg	Description: Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia
M1235	Doc pt hcv aby rna tst	Description: Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period
M1236	Baseline mrs > 2	Description: Baseline mrs > 2
M1237	Pt rsn no scrn	Description: 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)
M1238	Doc 2nd recom hzv 2-6 mo int	Description: 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)
M1239	Pt no resp heard	Description: Patient did not respond to the question of patient felt heard and understood by this provider and team
M1240	Pt no resp best int	Description: 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
M1241	Pt no resp seen as person	Description: 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
M1242	Pt no resp imprt to me	Description: Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life
M1243	Pt othr thn true heard	Description: Patient provided a response other than 'completely true' for the question of patient felt heard and understood by this provider and team
M1244	Pt othr thn true best int	Description: 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
M1245	Pt othr thn true person	Description: 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
M1246	Pt othr thn true imprt to me	Description: 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
M1247	Pt resp true best int	Description: 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
M1248	Pt resp true seen as person	Description: 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
M1249	Pt resp true imprt to me	Description: Patient responded 'completely tru' for the question of patient felt this provider and team understood what is important to me in my life
M1250	Pt resp true heard	Description: Patient responded as 'completely true' for the question of patient felt heard and understood by this provider and team
M1251	Pts proxy cmplt hu surv	Description: Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)
M1252	Pts no cmplt hu survey	Description: 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
M1253	Pts hu surv no amb plltv	Description: 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)
M1254	Pts deceased prior hu surv	Description: Patients who were deceased when the hu survey reached them
M1255	Pts w/ othr rsn vst,+prg tst	Description: 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)
M1256	Prior history of known cvd	Description: Prior history of known cvd
M1257	Cvd risk assess not perf	Description: Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified
M1258	Cvd risk assess perf	Description: Cvd risk assessment performed, have a documented calculated risk score
M1259	Pt stat doc <= 1 yr dialysis	Description: Patient status documented within the first year of initiating dialysis
M1260	Pt not doc <= 1 yr dialysis	Description: Patient status not documented within the first year of initiating dialysis
M1261	Pts on wtlist bef dialysis	Description: Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis
M1262	Pts transplt bef dialysis	Description: Patients who had a transplant prior to initiation of dialysis
M1263	Pts hosp dialysis dt	Description: Patients in hospice on their initiation of dialysis date or during the month of evaluation
M1264	Pts 75+ dialysis dt	Description: Patients age 75 or older on their initiation of dialysis date
M1265	Cms 2728 completed	Description: Cms medical evidence form 2728 for dialysis patients: initial form completed
M1266	Pts admit snf	Description: Patients admitted to a skilled nursing facility (snf)
M1267	Pt no act kid transplt wtlst	Description: 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
M1268	Pt ac stat kid trnsplt wtlst	Description: 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
M1269	Rec'd esrd mcp lst day of mo	Description: Receiving esrd mcp dialysis services by the provider on the last day of the reporting month
M1270	Pts no kid transplt wtlst	Description: Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period
M1271	Pts dem any time/dur mo	Description: Patients with dementia at any time prior to or during the month
M1272	Pts kid transplt wtlst	Description: Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period
M1273	Pts snf 1 yr dialysis	Description: Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form
M1274	Pts snf exl mo	Description: Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month
M1275	Pts hosp exl	Description: Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period
M1276	Calc bmi out nrm param nof/u	Description: Bmi documented outside normal parameters, no follow-up plan documented, no reason given
M1277	Colorectal ca screen doc rev	Description: Colorectal cancer screening results documented and reviewed
M1278	Pre-htn or htn doc, f/u indc	Description: Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented
M1279	Pre-htn/htn, no f/u, not gvn	Description: Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given
M1280	Bilat mast/hx bi /unilat mas	Description: 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
M1281	Bp scrn no perf at interval	Description: Blood pressure reading not documented, reason not given
M1282	Pt scrn tbco id as non user	Description: Patient screened for tobacco use and identified as a tobacco non-user
M1283	Pt scrn tbco and id as user	Description: Patient screened for tobacco use and identified as a tobacco user
M1284	Pt 66+ snp or ltc pos > 90d	Description: 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
M1285	Scrn mam perf rslts not doc	Description: Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified
M1286	Bmi doc onl fup not cmpltd	Description: Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason
M1287	Calc bmi blw low param f/u	Description: Bmi is documented below normal parameters and a follow-up plan is documented
M1288	Doc rsn no hbp scrn or f/u	Description: Documented reason for not screening or recommending a follow-up for high blood pressure
M1289	No pt tbco cess interv rng	Description: 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)
M1290	Pt not eli d/t act dig htn	Description: Patient not eligible due to active diagnosis of hypertension
M1291	Pt 66+ frailty and med dem	Description: 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
M1292	Pt 66+ frail inpt adv ill	Description: 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
M1293	Calc bmi abv up param f/u	Description: Bmi is documented above normal parameters and a follow-up plan is documented
M1294	Bp scrn perf rec interval	Description: Normal blood pressure reading documented, follow-up not required
M1295	Pt hx tot col or colon ca	Description: Patients with a diagnosis or past history of total colectomy or colorectal cancer
M1296	Calc bmi norm parameters	Description: Bmi is documented within normal parameters and no follow-up plan is required
M1297	Bmi not doc medrsn ptref	Description: Bmi not documented due to medical reason or patient refusal of height or weight measurement
M1298	Doc pt preg dur msrmt pd	Description: Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter
M1299	Flu immunize order/admin	Description: Influenza immunization administered or previously received
M1300	Flu imm no admin doc rea	Description: Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)
M1301	Pt recv tbco cess interv	Description: Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)
M1302	Scrn mam perf rslts doc	Description: Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed
M1303	Hospc serv dur meas pd	Description: Hospice services provided to patient any time during the measurement period
M1304	No pneum vax admin 19+	Description: Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period
M1305	Pneum vax admin 19+	Description: Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period
M1306	Pt anphx due to pneum	Description: Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period
M1307	Doc pt pal or hospice	Description: Documentation stating the patient has received or is currently receiving palliative or hospice care
M1308	Flu immunize no admin	Description: Influenza immunization was not administered, reason not given
M1309	Pall serv during meas	Description: Palliative care services provided to patient any time during the measurement period
M1310	Pt scr tob & cess int	Description: Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user
M1311	Aphlx to vax bef enc	Description: Anaphylaxis due to the vaccine on or before the date of the encounter
M1312	No pt tbco scrn rng	Description: Patient not screened for tobacco use
M1313	No tob scr/cess int	Description: Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period
M1314	Bmi not calculated	Description: Bmi not documented and no reason is given
M1315	Crc no doc no rsn	Description: Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified
M1316	Tobacco non-user	Description: Current tobacco non-user
M1317	Pts counsl cpt opt out	Description: Patients who are counseled on connection with a csp and explicitly opt out
M1318	Pts no csp doc contact	Description: Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp
M1319	Pts csp doc contact	Description: Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening
M1320	Pts scrn + hrsn	Description: Patients who screened positive for at least 1 of the 5 hrsns
M1321	Pts no 7wk inj,no iop,iop>25	Description: Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg
M1322	Pts 7wk inj, scrn iop =<25	Description: Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye
M1323	Pts 7wk inj, scrn iop >25	Description: Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented
M1324	Pts intravitreal/pci	Description: Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)
M1325	Doc med rsn not seen	Description: Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within seven (7) weeks of treatment)
M1326	Pts dx hypotony	Description: Patients with a diagnosis of hypotony
M1327	Pts no eval ini xm no 8 wks	Description: Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks
M1328	Pts dx acute vitreous hem	Description: Patients with a diagnosis of acute vitreous hemorrhage
M1329	Pts act pvd 2 wks 8 wks	Description: Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter
M1330	Doc pts rsn no f/u xm	Description: Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)
M1331	Pts eval ini xm 8 wks	Description: Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam
M1332	Pts no eval ini xm no 2 wks	Description: Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks
M1333	Acute vitreous hemorrhage	Description: Acute vitreous hemorrhage
M1334	Pts act pvd 2 wks 2 wks	Description: Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter
M1335	Doc pts rsn no f/u xm	Description: Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)
M1336	Pts eval ini xm 2 wks	Description: Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks
M1337	Acute pvd	Description: Acute pvd
M1338	Pt f/u 30-180 dys no + imprv	Description: Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period
M1339	Pts f/u 30-180 dys + improv	Description: Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance period
M1340	Indx whodas 2.0 or sds	Description: Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period
M1341	Pt no f/u 30-180 dys	Description: Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period
M1342	Pts died perf per	Description: Patients who died during the performance period
M1343	Pt pam lvl 4 base or srt lin	Description: Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam or with excessive missing responses
M1344	No bsln/2nd pam score 4-12mo	Description: Patients who did not have a baseline pam score and/or a second score within 4 to 12 months of baseline pam score
M1345	Pt bsln pam, 2nd scr 4-12 mo	Description: Patients who had a baseline pam score and a second score within 4 to 12 month of baseline pam score
M1346	No pam inc 6 pts 4-12 mo	Description: Patients who did not have a net increase in pam score of at least 6 points within a 4 to 12 month period
M1347	Pt pam incr 3 pt 4-12 mo	Description: Patients who achieved a net increase in pam score of at least 3 points in a 4 to 12 month period (passing)
M1348	Pam incr 6 pt 4-12 mo	Description: Patients who achieved a net increase in pam score of at least 6-points in a 4 to 12 month period (excellent)
M1349	No pam inc 3 pts 4-12 mo	Description: Patients who did not have a net increase in pam score of at least 3 points within a 4 to 12 month period
M1350	Pt w/ suic saf pln init rev	Description: Patients who had a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter
M1351	Pt cmplt suicd saf pln 120dy	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
M1352	Suicd c-ssrs assessment, equ	Description: Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment
M1353	Pts no cmplt suicd saf pln	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
M1354	Pt no suicd saf pln 120dy	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
M1355	Suicd based cln eval	Description: Suicide risk based on their clinician's evaluation or a clinician-rated tool
M1356	Pt died dur meas pd	Description: Patients who died during the measurement period
M1357	Pt w/red suic idea 120 days	Description: Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment
M1358	Pts no	Description: Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment
M1359	Indx suicd idea, no 0 scr	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
M1360	Suicd c-ssrs assessment	Description: Suicidal ideation and/or behavior symptoms based on the c-ssrs
M1361	Suicd based cln eval	Description: Suicide risk based on their clinician's evaluation or a clinician-rated tool
M1362	Pt died dur meas pd	Description: Patients who died during the measurement period
M1363	Pts no f/u 120 dys	Description: Patients who did not have a follow-up assessment within 120 days of the index assessment
M1364	Ascvd risk >=20pct	Description: Calculated 10-year ascvd risk score of >= 20 percent during the performance period
M1365	Hosp+pall care spec code 17	Description: Patient encounter during the performance period with hospice and palliative care specialty code 17
M1366	Focus on women's health mvp	Description: Focusing on women's health mips value pathway
M1367	Qual care ent disorder mvp	Description: Quality care for the treatment of ear, nose, and throat disorders mips value pathway
M1368	Prev trt inf d/o hiv/hep mvp	Description: Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway
M1369	Qualcare mental hlth/sud mvp	Description: Quality care in mental health and substance use disorders mips value pathway
M1370	Rehab support msk care mvp	Description: Rehabilitative support for musculoskeletal care mips value pathway
M1371	Mst rec gsa<7	Description: Most recent glycemic status assessment (hba1c or gmi) level < 7.0%
M1372	Mst rec gsa >=7 and<8	Description: Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%
M1373	Mst rec gsa >=8 and <=9	Description: Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%
M1374	Ra dx enc 90 days dur per pd	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
M1375	Ra dx enc 90 days dur per pd	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
M1376	Ra dx enc 90 days dur per pd	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
M1377	Fu colscop 10 yr doc w/ disc	Description: Recommended follow-up interval for repeat colonoscopy of 10 years documented in colonoscopy report and communicated with patient
M1378	Med rsn no 10 yr fu colscope	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)
M1379	10 yr fu no rec rsn not giv	Description: A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified
M1380	2 rx in perf pd any com meds	Description: Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under 'denominator note' or the long-acting injectable antipsychotic medications listed under 'denominator note'
M1381	Pt sec strk wthin 5 days	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
M1382	Enc dur perf pd pos 11	Description: Patient encounter during the performance period with place of service code 11
M1383	Acute pvd	Description: Acute pvd
M1384	Pt died dur perf pd	Description: Patients who died during the performance period
M1385	Pt rsn not seen 2nd pam	Description: Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up
M1386	Exc sx melmn or mlnm is	Description: Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period
M1387	Pt died dur perf pd	Description: Patients who died during the performance period
M1388	Pt doc exm rec melmn	Description: Patients with documentation of an exam performed for recurrence of melanoma
M1390	Pt no doc exm for rec	Description: Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period
M1391	All pt dx w/ rec mlnm	Description: All patients who were diagnosed with recurrent melanoma during the current performance period
M1392	Pt rsn no exm or lst to fu	Description: Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by phone, mail or secure electronic mail - at least one method must be documented)
M1393	Pr no dx rec mlnm	Description: Patients who were not diagnosed with recurrent melanoma during the current performance period
M1394	Stg i-iii br ca	Description: Stages i-iii breast cancer
M1395	Init chemo w/def dur ec grp	Description: Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group
M1396	Pt ther clin trial	Description: Patients on a therapeutic clinical trial
M1397	Pt w/ recur/prog	Description: Patients with recurrence/disease progression
M1398	Bslne and fu promis doc	Description: Patients with baseline and follow-up promis surveys documented in the medical record
M1399	Pt lve prac	Description: Patients who leave the practice during the follow-up period
M1400	Pt died dur perf pd	Description: Patients who died during the follow-up period
M1401	Stg i-iii br ca	Description: Stages i-iii breast cancer
M1402	Init chemo w/def dur ec grp	Description: Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group
M1403	Bslne and fu promis doc	Description: Patients with baseline and follow-up promis surveys documented in the medical record
M1404	Pt ther clin trial	Description: Patients on a therapeutic clinical trial
M1405	Pt w/ recur/prog	Description: Patients with recurrence/disease progression
M1406	Pt lve prac	Description: Patients who leave the practice during the follow-up period
M1407	Pt died dur perf pd	Description: Patients who died during the follow-up period
M1408	Gmln brca bef dx ca	Description: Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer
M1409	Recd gmln brca1/brca2 couns	Description: Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis
M1410	No gmln brca1/brca2 couns	Description: Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis
M1411	1st ln ici no chemo	Description: Currently on first-line immune checkpoint inhibitors without chemotherapy
M1412	Met nsclc w/ egfr alk oth ab	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
M1413	Pos pdl1 bef init ici tx	Description: Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy
M1414	Med rsn no pdl1 bef 1st ther	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)
M1415	No pos pdl1 bef ici ther	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
M1416	Pt rec hosp	Description: Patient received hospice services any time during the performance period
M1417	Pt up to date cov	Description: Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination
M1418	Med rsn not up to date cov	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
M1419	Pt not up to date cov	Description: Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination
M1420	Complete ophthalmologic mvp	Description: Complete ophthalmologic care mips value pathway
M1421	Dermatological care mvp	Description: Dermatological care mips value pathway
M1422	Gastroenterology care mvp	Description: Gastroenterology care mips value pathway
M1423	Opt care urologic cnd mvp	Description: Optimal care for patients with urologic conditions mips value pathway
M1424	Pulmonology care mvp	Description: Pulmonology care mips value pathway
M1425	Surgical care mvp	Description: Surgical care mips value pathway
P2028	Cephalin floculation test	Description: Cephalin floculation, blood
P2029	Congo red blood test	Description: Congo red, blood
P2031	Hair analysis	Description: Hair analysis (excluding arsenic)
P2033	Blood thymol turbidity	Description: Thymol turbidity, blood
P2038	Blood mucoprotein	Description: Mucoprotein, blood (seromucoid) (medical necessity procedure)
P3000	Screen pap by tech w md supv	Description: Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision
P3001	Screening pap smear by phys	Description: Screening papanicolaou smear, cervical or vaginal, up to three smears, requiring interpretation by physician
P7001	Culture bacterial urine	Description: Culture, bacterial, urine; quantitative, sensitivity study
P9010	Whole blood for transfusion	Description: Blood (whole), for transfusion, per unit
P9011	Blood split unit	Description: Blood, split unit
P9012	Cryoprecipitate each unit	Description: Cryoprecipitate, each unit
P9016	Rbc leukocytes reduced	Description: Red blood cells, leukocytes reduced, each unit
P9017	Plasma 1 donor frz w/in 8 hr	Description: Fresh frozen plasma (single donor), frozen within 8 hours of collection, each unit
P9019	Platelets, each unit	Description: Platelets, each unit
P9020	Plaelet rich plasma unit	Description: Platelet rich plasma, each unit
P9021	Red blood cells unit	Description: Red blood cells, each unit
P9022	Washed red blood cells unit	Description: Red blood cells, washed, each unit
P9023	Frozen plasma, pooled, sd	Description: Plasma, pooled multiple donor, solvent/detergent treated, frozen, each unit
P9025	Plasma cryo redu path each	Description: Plasma, cryoprecipitate reduced, pathogen reduced, each unit
P9026	Cryo fib comp path redu each	Description: Cryoprecipitated fibrinogen complex, pathogen reduced, each unit
P9027	Rbc o2 co2 reduced	Description: Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit
P9031	Platelets leukocytes reduced	Description: Platelets, leukocytes reduced, each unit
P9032	Platelets, irradiated	Description: Platelets, irradiated, each unit
P9033	Platelets leukoreduced irrad	Description: Platelets, leukocytes reduced, irradiated, each unit
P9034	Platelets, pheresis	Description: Platelets, pheresis, each unit
P9035	Platelet pheres leukoreduced	Description: Platelets, pheresis, leukocytes reduced, each unit
P9036	Platelet pheresis irradiated	Description: Platelets, pheresis, irradiated, each unit
P9037	Plate pheres leukoredu irrad	Description: Platelets, pheresis, leukocytes reduced, irradiated, each unit
P9038	Rbc irradiated	Description: Red blood cells, irradiated, each unit
P9039	Rbc deglycerolized	Description: Red blood cells, deglycerolized, each unit
P9040	Rbc leukoreduced irradiated	Description: Red blood cells, leukocytes reduced, irradiated, each unit
P9041	Albumin (human),5%, 50ml	Description: Infusion, albumin (human), 5%, 50 ml
P9043	Plasma protein fract,5%,50ml	Description: Infusion, plasma protein fraction (human), 5%, 50 ml
P9044	Cryoprecipitatereducedplasma	Description: Plasma, cryoprecipitate reduced, each unit
P9045	Albumin (human), 5%, 250 ml	Description: Infusion, albumin (human), 5%, 250 ml
P9046	Albumin (human), 25%, 20 ml	Description: Infusion, albumin (human), 25%, 20 ml
P9047	Albumin (human), 25%, 50ml	Description: Infusion, albumin (human), 25%, 50 ml
P9048	Plasmaprotein fract,5%,250ml	Description: Infusion, plasma protein fraction (human), 5%, 250 ml
P9050	Granulocytes, pheresis unit	Description: Granulocytes, pheresis, each unit
P9051	Blood, l/r, cmv-neg	Description: Whole blood or red blood cells, leukocytes reduced, cmv-negative, each unit
P9052	Platelets, hla-m, l/r, unit	Description: Platelets, hla-matched leukocytes reduced, apheresis/pheresis, each unit
P9053	Plt, pher, l/r cmv-neg, irr	Description: Platelets, pheresis, leukocytes reduced, cmv-negative, irradiated, each unit
P9054	Blood, l/r, froz/degly/wash	Description: Whole blood or red blood cells, leukocytes reduced, frozen, deglycerol, washed, each unit
P9055	Plt, aph/pher, l/r, cmv-neg	Description: Platelets, leukocytes reduced, cmv-negative, apheresis/pheresis, each unit
P9056	Blood, l/r, irradiated	Description: Whole blood, leukocytes reduced, irradiated, each unit
P9057	Rbc, frz/deg/wsh, l/r, irrad	Description: Red blood cells, frozen/deglycerolized/washed, leukocytes reduced, irradiated, each unit
P9058	Rbc, l/r, cmv-neg, irrad	Description: Red blood cells, leukocytes reduced, cmv-negative, irradiated, each unit
P9059	Plasma, frz between 8-24hour	Description: Fresh frozen plasma between 8-24 hours of collection, each unit
P9060	Fr frz plasma donor retested	Description: Fresh frozen plasma, donor retested, each unit
P9070	Pathogen reduced plasma pool	Description: Plasma, pooled multiple donor, pathogen reduced, frozen, each unit
P9071	Pathogen reduced plasma sing	Description: Plasma (single donor), pathogen reduced, frozen, each unit
P9072	Plate path red/rapid bac tes	Description: Platelets, pheresis, pathogen reduced or rapid bacterial tested, each unit
P9073	Platelets pheresis path redu	Description: Platelets, pheresis, pathogen-reduced, each unit
P9099	Blood component/product noc	Description: Blood component or product not otherwise classified
P9100	Pathogen test for platelets	Description: Pathogen(s) test for platelets
P9603	One-way allow prorated miles	Description: Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled
P9604	One-way allow prorated trip	Description: Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge
P9612	Catheterize for urine spec	Description: Catheterization for collection of specimen, single patient, all places of service
P9615	Urine specimen collect mult	Description: Catheterization for collection of specimen(s) (multiple patients)
Q0035	Cardiokymography	Description: Cardiokymography
Q0081	Infusion ther other than che	Description: Infusion therapy, using other than chemotherapeutic drugs, per visit
Q0083	Chemo by other than infusion	Description: Chemotherapy administration by other than infusion technique only (e.g., subcutaneous, intramuscular, push), per visit
Q0084	Chemotherapy by infusion	Description: Chemotherapy administration by infusion technique only, per visit
Q0085	Chemo by both infusion and o	Description: Chemotherapy administration by both infusion technique and other technique(s) (e.g., subcutaneous, intramuscular, push), per visit
Q0091	Obtaining screen pap smear	Description: Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory
Q0092	Set up port xray equipment	Description: Set-up portable x-ray equipment
Q0111	Wet mounts/ w preparations	Description: Wet mounts, including preparations of vaginal, cervical or skin specimens
Q0112	Potassium hydroxide preps	Description: All potassium hydroxide (koh) preparations
Q0113	Pinworm examinations	Description: Pinworm examinations
Q0114	Fern test	Description: Fern test
Q0115	Post-coital mucous exam	Description: Post-coital direct, qualitative examinations of vaginal or cervical mucous
Q0138	Ferumoxytol, non-esrd	Description: Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use)
Q0139	Ferumoxytol, esrd use	Description: Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (for esrd on dialysis)
Q0144	Azithromycin dihydrate, oral	Description: Azithromycin dihydrate, oral, capsules/powder, 1 gram
Q0155	Dronabinol (syndros) 0.1 mg	Description: Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Q0161	Chlorpromazine hcl 5mg oral	Description: Chlorpromazine hydrochloride, 5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Q0162	Ondansetron oral	Description: Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Q0163	Diphenhydramine hcl 50mg	Description: Diphenhydramine hydrochloride, 50 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at time of chemotherapy treatment not to exceed a 48 hour dosage regimen
Q0164	Prochlorperazine maleate 5mg	Description: Prochlorperazine maleate, 5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Q0166	Granisetron hcl 1 mg oral	Description: Granisetron hydrochloride, 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 24 hour dosage regimen
Q0167	Dronabinol 2.5mg oral	Description: Dronabinol, 2.5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Q0169	Promethazine hcl 12.5mg oral	Description: Promethazine hydrochloride, 12.5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Q0173	Trimethobenzamide hcl 250mg	Description: Trimethobenzamide hydrochloride, 250 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Q0175	Perphenazine 4mg oral	Description: Perphenazine, 4 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Q0177	Hydroxyzine pamoate 25mg	Description: Hydroxyzine pamoate, 25 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Q0180	Dolasetron mesylate oral	Description: Dolasetron mesylate, 100 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 24 hour dosage regimen
Q0181	Unspecified oral anti-emetic	Description: Unspecified oral dosage form, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for a iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Q0220	Tixagev and cilgav, 300mg	Description: Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), 300 mg
Q0221	Tixagev and cilgav, 600mg	Description: Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), 600 mg
Q0222	Bebtelovimab 175 mg	Description: Injection, bebtelovimab, 175 mg
Q0224	Inj, pemivibart, 4500 mg	Description: Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, and who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive medications or treatments, and are unlikely to mount an adequate immune response to covid-19 vaccination, 4500 mg
Q0235	Inj, monoclon antibody, 1 mg	Description: Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, not otherwise classified, 1 mg
Q0237	Inj, tocilizumab-anoh, hospi	Description: Injection, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg
Q0239	Bamlanivimab-xxxx	Description: Injection, bamlanivimab-xxxx, 700 mg
Q0240	Casirivi and imdevi 600 mg	Description: Injection, casirivimab and imdevimab, 600 mg
Q0243	Casirivimab and imdevimab	Description: Injection, casirivimab and imdevimab, 2400 mg
Q0244	Casirivi and imdevi 1200 mg	Description: Injection, casirivimab and imdevimab, 1200 mg
Q0245	Bamlanivimab and etesevima	Description: Injection, bamlanivimab and etesevimab, 2100 mg
Q0247	Sotrovimab	Description: Injection, sotrovimab, 500 mg
Q0249	Tocilizumab for covid-19	Description: Injection, 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, 1 mg
Q0477	Pwr module pt cable lvad rpl	Description: Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only
Q0478	Power adapter, combo vad	Description: Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type
Q0479	Power module combo vad, rep	Description: Power module for use with electric or electric/pneumatic ventricular assist device, replacement only
Q0480	Driver pneumatic vad, rep	Description: Driver for use with pneumatic ventricular assist device, replacement only
Q0481	Microprcsr cu elec vad, rep	Description: Microprocessor control unit for use with electric ventricular assist device, replacement only
Q0482	Microprcsr cu combo vad, rep	Description: Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only
Q0483	Monitor elec vad, rep	Description: Monitor/display module for use with electric ventricular assist device, replacement only
Q0484	Monitor elec or comb vad rep	Description: Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only
Q0485	Monitor cable elec vad, rep	Description: Monitor control cable for use with electric ventricular assist device, replacement only
Q0486	Mon cable elec/pneum vad rep	Description: Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only
Q0487	Leads any type vad, rep only	Description: Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only
Q0488	Pwr pack base elec vad, rep	Description: Power pack base for use with electric ventricular assist device, replacement only
Q0489	Pwr pck base combo vad, rep	Description: Power pack base for use with electric/pneumatic ventricular assist device, replacement only
Q0490	Emr pwr source elec vad, rep	Description: Emergency power source for use with electric ventricular assist device, replacement only
Q0491	Emr pwr source combo vad rep	Description: Emergency power source for use with electric/pneumatic ventricular assist device, replacement only
Q0492	Emr pwr cbl elec vad, rep	Description: Emergency power supply cable for use with electric ventricular assist device, replacement only
Q0493	Emr pwr cbl combo vad, rep	Description: Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only
Q0494	Emr hd pmp elec/combo, rep	Description: Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only
Q0495	Charger elec/combo vad, rep	Description: Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only
Q0496	Battery elec/combo vad, rep	Description: Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only
Q0497	Bat clps elec/comb vad, rep	Description: Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only
Q0498	Holster elec/combo vad, rep	Description: Holster for use with electric or electric/pneumatic ventricular assist device, replacement only
Q0499	Belt/vest elec/combo vad rep	Description: Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only
Q0500	Filters elec/combo vad, rep	Description: Filters for use with electric or electric/pneumatic ventricular assist device, replacement only
Q0501	Shwr cov elec/combo vad, rep	Description: Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only
Q0502	Mobility cart pneum vad, rep	Description: Mobility cart for pneumatic ventricular assist device, replacement only
Q0503	Battery pneum vad replacemnt	Description: Battery for pneumatic ventricular assist device, replacement only, each
Q0504	Pwr adpt pneum vad, rep veh	Description: Power adapter for pneumatic ventricular assist device, replacement only, vehicle type
Q0506	Lith-ion batt elec/pneum vad	Description: Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only
Q0507	Misc sup/acc ext vad	Description: Miscellaneous supply or accessory for use with an external ventricular assist device
Q0508	Mis sup/acc imp vad	Description: Miscellaneous supply or accessory for use with an implanted ventricular assist device
Q0509	Mis sup/ac imp vad nopay med	Description: Miscellaneous supply or accessory for use with any implanted ventricular assist device for which payment was not made under medicare part a
Q0510	Dispens fee immunosupressive	Description: Pharmacy supply fee for initial immunosuppressive drug(s), first month following transplant
Q0511	Sup fee antiem,antica,immuno	Description: Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period
Q0512	Px sup fee anti-can sub pres	Description: Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period
Q0513	Disp fee inhal drugs/30 days	Description: Pharmacy dispensing fee for inhalation drug(s); per 30 days
Q0514	Disp fee inhal drugs/90 days	Description: Pharmacy dispensing fee for inhalation drug(s); per 90 days
Q0515	Sermorelin acetate injection	Description: Injection, sermorelin acetate, 1 microgram
Q0516	Supply fee hiv prep oral 30	Description: Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription oral drug, per 30-days
Q0517	Supply fee hiv prep oral 60	Description: Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription oral drug, per 60-days
Q0518	Supply fee hiv prep oral 90	Description: Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription oral drug, per 90-days
Q0519	Supply fee hiv prep inj 30	Description: Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription injectable drug, per 30-days
Q0520	Supply fee hiv prep inj 60	Description: Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription injectable drug, per 60-days
Q0521	Supply fee hiv prep fda appr	Description: Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription
Q1004	Ntiol category 4	Description: New technology intraocular lens category 4 as defined in federal register notice
Q1005	Ntiol category 5	Description: New technology intraocular lens category 5 as defined in federal register notice
Q2004	Bladder calculi irrig sol	Description: Irrigation solution for treatment of bladder calculi, for example renacidin, per 500 ml
Q2009	Fosphenytoin inj pe	Description: Injection, fosphenytoin, 50 mg phenytoin equivalent
Q2026	Radiesse injection	Description: Injection, radiesse, 0.1 ml
Q2028	Inj, sculptra, 0.5mg	Description: Injection, sculptra, 0.5 mg
Q2034	Agriflu vaccine	Description: Influenza virus vaccine, split virus, for intramuscular use (agriflu)
Q2035	Afluria vacc, 3 yrs & >, im	Description: Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (afluria)
Q2036	Flulaval vacc, 3 yrs & >, im	Description: Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (flulaval)
Q2037	Fluvirin vacc, 3 yrs & >, im	Description: Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluvirin)
Q2038	Fluzone vacc, 3 yrs & >, im	Description: Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone)
Q2039	Influenza virus vaccine, nos	Description: Influenza virus vaccine, not otherwise specified
Q2040	Tisagenlecleucel car-pos t	Description: Tisagenlecleucel, up to 250 million car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion
Q2041	Axicabtagene ciloleucel car+	Description: Axicabtagene ciloleucel, up to 200 million autologous anti-cd19 car positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose
Q2042	Tisagenlecleucel car-pos t	Description: Tisagenlecleucel, up to 600 million car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose
Q2043	Sipuleucel-t auto cd54+	Description: Sipuleucel-t, minimum of 50 million autologous cd54+ cells activated with pap-gm-csf, including leukapheresis and all other preparatory procedures, per infusion
Q2049	Imported lipodox inj	Description: Injection, doxorubicin hydrochloride, liposomal, imported lipodox, 10 mg
Q2050	Doxorubicin inj 10mg	Description: Injection, doxorubicin hydrochloride, liposomal, not otherwise specified, 10 mg
Q2052	Home ivig, services/supplies	Description: Services, supplies and accessories used in the home for the administration of intravenous immune globulin (ivig)
Q2053	Brexucabtagene car pos t	Description: Brexucabtagene autoleucel, up to 200 million autologous anti-cd19 car positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose
Q2054	Lisocabtagene mara car pos t	Description: Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose
Q2055	Idecabtagene vicleucel car	Description: Idecabtagene vicleucel, up to 510 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose
Q2056	Ciltacabtagene car-pos t	Description: Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose
Q3001	Brachytherapy radioelements	Description: Radioelements for brachytherapy, any type, each
Q3014	Telehealth facility fee	Description: Telehealth originating site facility fee
Q3027	Inj beta interferon im 1 mcg	Description: Injection, interferon beta-1a, 1 mcg for intramuscular use
Q3028	Inj beta interferon sq 1 mcg	Description: Injection, interferon beta-1a, 1 mcg for subcutaneous use
Q3031	Collagen skin test	Description: Collagen skin test
Q4001	Cast sup body cast plaster	Description: Casting supplies, body cast adult, with or without head, plaster

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