M1202 – Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)

Long 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)

Short description

Pt rsn no ace-i/arb rx

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

• 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)
• M1195 – 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 – Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4
• M1197 – Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score
• M1198 – 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 – Patients receiving rrt
• M1200 – Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period
• M1201 – 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)
• M1203 – Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given
• M1204 – Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4
• M1205 – Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score
• M1206 – 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 – Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety
• M1208 – Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety
• M1209 – At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses
• M1210 – At least two orders for high-risk medications from the same drug class, (table 4), not ordered