M1478 – Psychoactive substance abuse

Long description

Psychoactive substance abuse

Short description

Psychoactive sub abuse

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

• M1470 – Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine)
• M1471 – Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules
• M1472 – Patient did not receive recommended doses of hepatitis b vaccination based on age
• M1473 – Patient situations, at any point during the denominator identification period, where the patient's functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders
• M1474 – Patients with diagnosis of dementia
• M1475 – Patients with diagnosis of huntington's disease
• M1476 – Patients with diagnosis of cognitive impairment or alzheimer's disease
• M1477 – Diagnosis of delirium
• M1479 – Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders
• M1480 – Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders
• M1481 – Patients receiving hospice or palliative care or who died during the measurement period
• M1482 – Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period
• M1483 – Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period
• M1484 – Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)
• M1485 – Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period
• M1486 – Patients admitted to a skilled nursing facility (snf) during the period of evaluation