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)

Long description

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)

Short description

Med rsn no 10 yr fu colscope

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

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• 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
• 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
• 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
• 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"
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• M1382 – Patient encounter during the performance period with place of service code 11
• M1383 – Acute pvd
• M1384 – Patients who died during the performance period
• M1385 – Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up
• M1386 – Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period