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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 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 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 CPT code 4052F

Hemodialysis via functioning arteriovenous (AV) fistula (ESRD).

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 2035F

Documents the assessment of tympanic membrane mobility using pneumatic otoscopy or tympanometry in patients diagnosed with otitis media with effusion (OME).

2025 CPT code 3301F

Documents the review and classification of cancer as metastatic in a patient 18 years or older, using the AJCC system.

2025 CPT code 2050F

Documents wound characteristics including size, nature of wound base tissue, and amount of drainage before debridement (CWC).

2025 CPT code 4340F

Counseling for women of childbearing potential with epilepsy.

2025 HCPCS code M1127

Report this quality measure code when a patient is diagnosed with a degenerative neurological condition (ALS, MS, Parkinson's disease, or other) before or during an episode of care.

2025 CPT code 1153F

Documents advanced disease diagnosis where comfort is not the primary goal of care.

2025 HCPCS code G8655

Calculation of residual score for lower leg, foot, or ankle impairment; score is 0 or greater.

2025 CPT code 3322F

Melanoma greater than AJCC Stage 0 or IA.

2025 CPT code 1134F

Episode of back pain lasting 6 weeks or less (BkP).

2025 HCPCS code G0059

This HCPCS code signifies provider participation in the Medicare Merit-based Incentive Payment System (MIPS) Value Pathways (MVP) program for Patient Safety and Support of Positive Experiences with Anesthesia.

2025 HCPCS code G9813

Tracks patient mortality within 30 days post-procedure or during hospitalization.

2025 HCPCS code G8967

Prescription of warfarin or another FDA-approved oral anticoagulant.

2025 CPT code 1159F

Medication list documented in the medical record.

2025 CPT code 4556F

This CPT Category II code tracks patients exhibiting three or more risk factors for post-operative nausea and vomiting (PONV).

2025 HCPCS code G0032

Two or more antipsychotic prescriptions ordered for patients diagnosed with schizophrenia, schizoaffective disorder, or bipolar disorder within a specified timeframe.

2025 HCPCS code G0054

Indicates provider participation in the Coordinating Stroke Care MIPS Value Pathways (MVP) program; not a billable service.

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