HCPCS Code Section: HCPCS M Codes

Patient immunocompromised Short Description: Pt imcomprmd Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2019 Effective Date: January 1, 2019 Termination Date:

Patient pregnancy Short Description: Pt preg Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2019 Effective Date: January 1, 2019 Termination Date:

Patient died prior to the end of the performance period Short Description: Pt died in pp Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: …

Patient was in hospice or receiving palliative care at any time during the performance period Short Description: Pt no prm nurs hm res in pp Coverage Code: Carrier judgment …

Patient was a permanent nursing home resident at any time during the performance period Short Description: Pt prm nurs hm res in pp Coverage Code: Carrier judgment Action Code: …

Aspirin or another antiplatelet therapy not used, reason not given Short Description: Aspirin not used, no rsn Coverage Code: Carrier judgment Action Code: No maintenance for this code Date …

Prescribed anticoagulant medication during the performance period, history of gi bleeding, history of intracranial bleeding, bleeding disorder and specific provider documented reasons: allergy to aspirin or anti-platelets, use of …

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 …

Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy Short Description: Pt had add’l sp pcr perf Coverage Code: Carrier judgment Action Code: …

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 …