HCPCS Code Section: HCPCS M Codes

Patient had only urgent care visits during the performance period Short Description: Pt uc in pp Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: …

Patient screened for future fall risk Short Description: Pt scr ft fall rsk Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2019 …

Leg pain was measured by the visual analog scale (vas) within three months preoperatively and at one year (9 to 15 months) postoperatively Short Description: Pre and post vas …

Adults who are not ambulatory Short Description: Pt not ambulatory Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2019 Effective Date: January …

Leg pain was not measured by the visual analog scale (vas) at one year (9 to 15 months) postoperatively Short Description: Lg pn not meas w/ vas 1yr po …

Hospice services for patient provided any time during the measurement period Short Description: Hspc pt prv time meam per Coverage Code: Carrier judgment Action Code: No maintenance for this …

Patient had cancer, fracture or infection related to the lumbar spine or patient had idiopathic or congenital scoliosis Short Description: Pt w/cancer scoliosis Coverage Code: Carrier judgment Action Code: …

The start of an episode of care documented in the medical record Short Description: Start eoc doc med rec Coverage Code: Carrier judgment Action Code: Add procedure or modifier …

Ongoing care not indicated, patient self-discharged early and seen only 1-2 visits (e.g., financial or insurance reasons, transportation problems, or reason unknown) Short Description: Oc ni pt selfdc 1-2 …

Ongoing care not indicated, patient discharged after only 1-2 visits due to specific medical events, documented in the medical record that make the treatment episode impossible such as the …