M1186 – Patients who have an order for or are receiving hospice or palliative care

Long description

Patients who have an order for or are receiving hospice or palliative care

Short description

Pt w/ rx for hspc/plltv care

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, 2023

Last change

January 1, 2023 – No change

Nearby M codes

• M1178 – Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)
• M1179 – Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period
• M1180 – Patients on immune checkpoint inhibitor therapy
• M1181 – Grade 2 or above diarrhea and/or grade 2 or above colitis
• M1182 – Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohn's disease)
• M1183 – Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered
• M1184 – 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 – Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given
• M1187 – Patients with a diagnosis of end stage renal disease (esrd)
• M1188 – Patients with a diagnosis of chronic kidney disease (ckd) stage 5
• M1189 – Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed
• M1190 – 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 – Hospice services provided to patient any time during the measurement period
• M1192 – Patients with an existing diagnosis of squamous cell carcinoma of the esophagus
• M1193 – 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 – 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)