M1433 – Patient on oral chemotherapy on or within 30 days before denominator eligible encounter

Long description

Patient on oral chemotherapy on or within 30 days before denominator eligible encounter

Short description

Oral chemo wthn 30 days enc

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, 2026

Last change

January 1, 2026 – No change

Nearby M codes

• M1425 – Surgical care mips value pathway
• M1426 – Encounters conducted via telehealth
• M1427 – Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)
• M1428 – Patients who have bilateral absence of eyes any time during the patient's history through the end of the measurement period
• M1429 – Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented
• M1430 – Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)
• M1431 – Encounters conducted via telehealth
• M1432 – Encounters conducted via telehealth
• M1434 – Patient on oral chemotherapy on or within 30 days after denominator eligible encounter
• M1435 – Patient on oral chemotherapy during the performance period
• M1436 – Encounters conducted via telehealth
• M1437 – Encounters conducted via telehealth
• M1438 – Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)
• M1439 – Significant ocular conditions that impact the visual outcome of surgery
• M1440 – Encounters conducted via telehealth
• M1441 – Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient