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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 M1365

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

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 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 HCPCS code M1113

Ongoing care not clinically indicated; patient seen for only one to two visits (e.g., home program only, referred to another provider, consultation only).

2025 HCPCS code M1153

This HCPCS Level II code tracks patients diagnosed with osteoporosis on the date of encounter.

2025 HCPCS code M1202

Documentation of reasons for not prescribing ACE inhibitors or ARBs during a specific measurement period.

2025 HCPCS code G2173

URI episodes with comorbid condition in prior 12 months.

2025 CPT code 2022F

Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist documented and reviewed; with evidence of retinopathy.

2025 CPT code 1460F

Qualifying cardiac event/diagnosis in previous 12 months (CAD).

2025 CPT code 1450F

Symptoms improved or remained consistent with treatment goals since last assessment (HF).

2025 CPT code 1007F

Use of anti-inflammatory or analgesic over-the-counter (OTC) medications for symptom relief assessed.

2025 CPT code 1012F

This code documents the absence of angina in a patient with coronary artery disease (CAD).

2025 CPT code 1091F

Urinary incontinence characterized (e.g., frequency, volume, timing, type of symptoms, how bothersome).

2025 CPT code 2040F

Physical examination performed on the date of the initial visit for low back pain, in accordance with specifications.

2025 CPT code 3082F

Kt/V less than 1.2 (Clearance of urea [Kt]/volume [V]) (ESRD, P-ESRD).

2025 CPT code 3083F

Kt/V equal to or greater than 1.2 and less than 1.7 (Clearance of urea [Kt]/volume [V]).

2025 CPT code 1124F

Advance care planning discussed and documented, but the patient declined or was unable to name a surrogate decision-maker or provide an advance care plan.

2025 CPT code 3216F

Patient has documented immunity to Hepatitis B.

2025 CPT code 6101F

Safety counseling for dementia provided.

2025 CPT code 4561F

Patient has a coronary artery stent (Peri2).

2025 CPT code 4562F

Patient does not have a coronary artery stent (Peri2).

2025 CPT code 5015F

Documents communication about a fracture and the need for osteoporosis testing or treatment.

2025 CPT code 5010F

Documents communication of dilated macular or fundus exam findings to the physician managing diabetes care.

2025 CPT code P3

Performance Measure Exclusion Modifier due to System Reasons.

2025 CPT code 4555F

Patient did not receive inhalational anesthetic agent.

2025 CPT code 1101F

Patient screened for future fall risk; documentation of no falls in the past year or only one fall without injury.

2025 CPT code 2000F

Blood pressure measured (CKD)(DM)

2025 CPT code 1006F

Assessment of osteoarthritis symptoms and functional status, possibly using standardized scales like the SF-36 or AAOS Hip & Knee Questionnaire.Report this code when osteoarthritis is addressed during the patient encounter.

2025 CPT code 2030F

Hydration status documented, normally hydrated.

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 M1179

Patient aged 60 or older did not receive pneumococcal vaccine before the end of the measurement period.

2025 HCPCS code G9422

This HCPCS code tracks the documentation of pT and pN categories and histological type in primary lung carcinoma resection reports.

2025 CPT code 4500F

Referral to an outpatient cardiac rehabilitation program for coronary artery disease (CAD).

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."