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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 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

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

2025 HCPCS code M1172

Documentation of medical reason(s) for not administering TD or Tdap vaccine.

2025 HCPCS code M1213

No history of spirometry results with confirmed airflow obstruction (FEV1/FVC < 70%) and present spirometry is ≥ 70%

2025 HCPCS code G0050

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

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 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 3650F

Electroencephalogram (EEG) ordered, reviewed, or requested.

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 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.