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ALL MEDICAL CODES IN CATEGORY Performance Measurement

2025 CPT Category II code 1158F

Documents an advance care planning discussion in the medical record.

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 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 M1333

Acute vitreous hemorrhage.

2025 HCPCS code M1134

Reports when a patient discontinues ongoing care due to early self-discharge (e.g., financial, insurance, or transportation reasons).

2025 HCPCS code M1200

Tracks the prescription of ACE inhibitors or ARBs during a specified measurement period.

2025 CPT code 3266F

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

2025 HCPCS code M1209

Tracking code indicating at least two orders for high-risk medications from the same drug class without appropriate diagnoses.

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 4558F

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

2025 CPT code 2028F

Foot examination performed, including visual inspection, sensory exam with monofilament, and pulse exam. Report when any of the three components are completed.

2025 CPT code 7025F

Patient information entered into a reminder system with a target due date for the next mammogram (RAD).

2025 CPT code 1220F

Patient screened for depression (SUD).

2025 CPT code 3037F

Oxygen saturation greater than 88% or PaO2 greater than 55 mm Hg (COPD).

2025 CPT code 3496F

CD4+ cell count ≥500 cells/mm3 (HIV)

2025 CPT code 3452F

Dyspnea not screened (Pall Cr).

2025 CPT code 3455F

Tuberculosis (TB) screening performed and results interpreted within six months prior to initiation of first-time biologic disease modifying anti-rheumatic drug (DMARD) therapy for rheumatoid arthritis (RA).

2025 CPT code 1070F

Alarm symptoms (involuntary weight loss, dysphagia, or gastrointestinal bleeding) assessed; none present (GERD).

2025 CPT code 4300F

Patient receiving warfarin therapy for nonvalvular atrial fibrillation or atrial flutter (AFIB).

2025 CPT code 3382F

Documentation of AJCC stage 0 colon cancer in a patient 18 years or older.

2025 CPT code 4196F

Documents that the patient is not receiving first-time biologic disease-modifying anti-rheumatic drug (DMARD) therapy for rheumatoid arthritis (RA).

2025 HCPCS code G9700

Indicates patient received hospice services during the measurement period.

2025 HCPCS code G9719

This HCPCS code tracks patients who are not ambulatory, bedridden, immobile, or require assistance with mobility.

2025 HCPCS code G9688

Indicates that the patient received hospice care during the measurement period.

2025 CPT code 2019F

Dilated macular exam performed, documenting macular thickening, hemorrhage, and macular degeneration severity.

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 HCPCS code M1161

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

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 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 HCPCS code M1135