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

Long 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

Short description

Ongoing care not ind

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, 2021

Last change

January 1, 2021 – No change

Nearby M codes

• 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)
• 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
• M1150 – 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 – Patients with a history of heart transplant or with a left ventricular assist device (lvad)
• M1152 – Patients with a history of heart transplant or with a left ventricular assist device (lvad)
• M1153 – Patient with diagnosis of osteoporosis on date of encounter
• M1154 – Hospice services provided to patient any time during the measurement period