M1284 – 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

Long 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

Short description

Pt 66+ snp or ltc pos > 90d

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, 2024

Last change

January 1, 2024 – No change

Nearby M codes

• M1276 – Bmi documented outside normal parameters, no follow-up plan documented, no reason given
• M1277 – Colorectal cancer screening results documented and reviewed
• M1278 – Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented
• M1279 – Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given
• M1280 – 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 – Blood pressure reading not documented, reason not given
• M1282 – Patient screened for tobacco use and identified as a tobacco non-user
• M1283 – Patient screened for tobacco use and identified as a tobacco user
• M1285 – Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified
• M1286 – Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason
• M1287 – Bmi is documented below normal parameters and a follow-up plan is documented
• M1288 – Documented reason for not screening or recommending a follow-up for high blood pressure
• M1289 – 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 – Patient not eligible due to active diagnosis of hypertension
• M1291 – 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 – 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