M1375 – An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period

Long description

An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period

Short description

Ra dx enc 90 days dur per pd

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, 2025

Last change

January 1, 2025 – No change

Nearby M codes

• M1367 – Quality care for the treatment of ear, nose, and throat disorders mips value pathway
• M1368 – Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway
• M1369 – Quality care in mental health and substance use disorders mips value pathway
• M1370 – Rehabilitative support for musculoskeletal care mips value pathway
• M1371 – Most recent glycemic status assessment (hba1c or gmi) level < 7.0%
• M1372 – Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%
• M1373 – Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%
• M1374 – An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period
• M1376 – An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period
• M1377 – Recommended follow-up interval for repeat colonoscopy of 10 years documented in colonoscopy report and communicated with patient
• M1378 – Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)
• M1379 – A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified
• M1380 – Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under "denominator note" or the long-acting injectable antipsychotic medications listed under "denominator note"
• M1381 – Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure
• M1382 – Patient encounter during the performance period with place of service code 11
• M1383 – Acute pvd