2025 CPT code 1160F
(Active) Effective Date: N/A Revision Date: N/A Performance Measurement - Patient History Category II Codes Feed
Review of all medications (prescriptions, OTCs, herbal therapies, supplements) documented in the medical record by a prescribing practitioner or clinical pharmacist.
Category II codes do not utilize modifiers.
Medical necessity for this code is established by the need for comprehensive medication review to ensure patient safety and appropriate medication management. This is particularly important for patients with complex medical histories or those taking multiple medications. The review aims to prevent adverse drug events and optimize treatment efficacy.
The clinical responsibility for this code lies with the prescribing practitioner or clinical pharmacist who reviews and documents the patient's medication list.
In simple words: The doctor or pharmacist checked all the patient's medicines—prescription drugs, over-the-counter drugs, and supplements—and made a note of them in the patient's file.
This CPT Category II code represents a review of all medications taken by a patient, including prescriptions, over-the-counter medications, herbal therapies, and supplements.The review must be performed by a prescribing practitioner or clinical pharmacist and documented in the patient's medical record. This code is used for performance measurement and is not associated with a relative value or direct reimbursement.It's intended to improve data collection related to medication reconciliation and patient care quality.
Example 1: A patient presents for a routine check-up. The physician reviews the patient's medication list, including prescriptions, OTC medications, and herbal supplements, and documents this review in the medical record. Code 1160F is used for reporting this comprehensive medication review., A pharmacist conducts a medication reconciliation for a patient being discharged from the hospital. The pharmacist reviews the patient's home medications, compares them to the medications administered during hospitalization, and documents any discrepancies or necessary adjustments.Code 1160F is reported to reflect the pharmacist's comprehensive medication review., A patient is transitioning care from one physician to another. The new physician performs a comprehensive review of the patient's current medication regimen to ensure medication safety and efficacy. Code 1160F is used to report the documentation of this medication review.
The medical record must contain documentation of the medication review, including a list of all medications taken by the patient (prescriptions, OTCs, herbal remedies, supplements) and the date of the review. The reviewer's credentials (physician or pharmacist) should also be evident.
** This code is often used in conjunction with other Category II codes related to medication management and patient care quality measures.The use of this code is optional and depends on the specific requirements of the reporting entity or payer.
- RVU: No relative value units are associated with this Category II code.
- Global Days : Not applicable to Category II codes.
- Payment Status: Non-reimbursable; billed with a $0.00 or $0.01 charge amount.
- Modifier TC rule: Not applicable to Category II codes.
- Fee Schedule : No fee is associated with this Category II code.
- Specialties:Family Medicine, Internal Medicine, Cardiology, Pharmacy, Geriatrics
- Place of Service:Office, Hospital Inpatient, Hospital Outpatient, Skilled Nursing Facility, Pharmacy