M1040 – Patients with a diagnosis of lumbar idiopathic or congenital scoliosis

Long description

Patients with a diagnosis of lumbar idiopathic or congenital scoliosis

Short description

Pt dx lum idi or cong scol

Pricing indicator

00 Not separately priced by Part B (bundled, not covered or Part A only)

Medicare coverage

C Carrier judgment – coverage decided by the Medicare contractor

BETOS category

Z2 Undefined codes

Added

January 1, 2019

Last change

January 1, 2019 – No change

Nearby M codes

• 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
• 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