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ALL MEDICAL CODES IN CATEGORY Performance Measurement

2025 HCPCS code M1365

Records a patient encounter with a hospice and palliative care provider (specialty code 17) during a performance period.

2025 CPT code 5200F

Consideration of referral for a neurological evaluation of appropriateness for surgical therapy for intractable epilepsy within the past 3 years.

2025 CPT code 3328F

Performance status documented and reviewed within 2 weeks prior to surgery (Lung/Esop Cx).

2025 CPT code 3293F

ABO and Rh blood typing documented as performed.

2025 CPT code 4265F

Use of wet to dry dressings prescribed or recommended.

2025 HCPCS code M1170

Patient did not receive an influenza vaccine between July 1st of the prior year and June 30th of the current year.

2025 CPT code 4077F

Documents that the administration of tissue plasminogen activator (t-PA) was considered.

2025 CPT code 1052F

Type, anatomic location, and activity all assessed (IBD).

2025 CPT code 1040F

DSM-5 criteria for major depressive disorder documented at the initial evaluation.

2025 CPT code 1060F

Documentation of permanent or persistent or paroxysmal atrial fibrillation.

2025 HCPCS code M1248

Patient responded "completely true" to the question of whether they felt the provider and team saw them as a person, not just someone with a medical problem.

2025 HCPCS code M1161

Patient had anaphylaxis due to tetanus, diphtheria, or pertussis vaccine on or before 13th birthday.

2025 HCPCS code G0050

This code is used for performance measurement and tracks patients with a catheter who have a limited life expectancy.

2025 HCPCS code M1246

Patient did not report "completely true" to the question, "Patient felt this provider and team understood what is important to me in my life."

2025 HCPCS code G9782

History of or active diagnosis of familial hypercholesterolemia.

2025 HCPCS code G8708

This code is used to track when a patient is not prescribed an antibiotic.

2025 Modifier code P1

Performance Measure Exclusion Modifier due to Medical Reasons.

2025 HCPCS code M1333

Acute vitreous hemorrhage.

2025 HCPCS code M1121

Episode of care documented in medical record.

2025 HCPCS code M1106

The start of an episode of care documented in the medical record.

2025 HCPCS code M1150

Left ventricular ejection fraction (LVEF) less than or equal to 40% or moderately/severely depressed left ventricular systolic function.

2025 HCPCS code M1163

Patient had anaphylaxis due to the HPV vaccine on or before the patient's 13th birthday. This is a tracking code for performance measurement.

2025 HCPCS code M1203

This code is used for patients with chronic kidney disease and proteinuriawho were not prescribed ACE inhibitor or ARB therapy during the measurement period, and no reason was given for not prescribing.

2025 HCPCS code M1147

Ongoing care not medically possible due to early discharge for medical reasons.

2025 HCPCS code M1167

Indicates the patient received hospice services during the measurement period for performance tracking.

2025 HCPCS code M1146

Ongoing care not clinically indicated due to patient needing home program, referral, or consultation only.

2025 HCPCS code M1155

Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period.

2025 HCPCS code M1201

Documentation of medical reason(s) for not prescribing ACE inhibitor (ACE-I) or ARB therapy during the measurement period.

2025 HCPCS code M1182

Patient is not eligible due to pre-existing inflammatory bowel disease (IBD).

2025 HCPCS code M1304

Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period.

2025 HCPCS code M1231

Patient receives HCV antibody test with nonreactive result.

2025 HCPCS code M1230

Patient with reactive HCV antibody test without follow-up viral test, or with follow-up test detecting viremia but no referral or treatment initiated within specified timeframes, reason not given.

2025 HCPCS code M1273

Patient admitted to a skilled nursing facility (SNF) within one year of dialysis initiation, documented on CMS-2728.

2025 HCPCS code M1280

History of Bilateral Mastectomy

2025 HCPCS code M1341

This code tracks the absence of a follow-up assessment or its occurrence outside the 30-180 day window after the initial assessment, relevant to specific performance programs.

2025 CPT code 4559F

At least one body temperature measurement equal to or greater than 35.5 degrees Celsius (or 95.9 degrees Fahrenheit) recorded within the 30 minutes immediately before or the 15 minutes immediately after anesthesia end time.

2025 CPT code 3266F

Documents Hepatitis C genotype testing performed before starting antiviral treatment for Hepatitis C.

2025 CPT code 4558F

Patient received at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and intraoperatively.

2025 CPT code 4084F

Aspirin received within 24 hours before emergency department arrival or during emergency department stay (EM).

2025 CPT code 3344F

Documents a mammogram assessment categorized as "suspicious".

2025 CPT code 3354F

Clinically significant depressive symptoms as categorized by using a standardized depression screening/assessment tool.

2025 CPT code 4086F

Aspirin or clopidogrel prescribed or currently being taken for patients with Coronary Artery Disease (CAD).

2025 CPT code 0517F

Glaucoma plan of care documented.

2025 CPT code P3

Performance Measure Exclusion Modifier due to System Reasons.

2025 CPT code 2021F

Dilated macular or fundus exam performed, including documentation of the presence or absence of macular edema and level of severity of retinopathy.

2025 CPT code 3512F

Syphilis screening documented as performed.

2025 CPT code 3320F

None of the following diagnostic imaging studies ordered: chest X-ray, CT, Ultrasound, MRI, PET, or nuclear medicine scans.

2025 CPT code 0583F

Transfer of care checklist used.

2025 CPT code 6005F

Rationale (e.g., severity of illness and safety) for level of care (e.g., home, hospital) documented.

2025 HCPCS code G2173

URI episodes with comorbid condition in prior 12 months.