HCPCS code lookup
HCPCS Level II
Category M
Medical services. CMS HCPCS Level II file dated September 23, 2026.
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Codes
- M1043Functional status was not measured by the oswestry disability index (odi version 2.1a) at one year (9 to 15 months) postoperatively
- M1044Functional status was measured by the oswestry disability index (odi version 2.1a) patient reported outcome tool within three months preoperatively and at one year (9 to 15 months) postoperatively
- M1045Functional status measured by the oxford knee score (oks) at one year (9 to 15 months) postoperatively was greater than or equal to 37 or knee injury and osteoarthritis outcome score joint replacement (koos, jr.) was greater than or equal to 71
- M1046Functional status measured by the oxford knee score (oks) at one year (9 to 15 months) postoperatively was less than 37 or the knee injury and osteoarthritis outcome score joint replacement (koos, jr.) was less than 71 postoperatively
- M1047Functional status was measured by the oxford knee score (oks) patient reported outcome tool within three months preoperatively and at one year (9 to 15 months) postoperatively
- M1048Functional status measurement with score was obtained utilizing the oswestry disability index (odi version 2.1a) patient reported outcome tool within three months preoperatively and at three months (6 to 20 weeks) postoperatively
- M1049Functional status was not measured by the oswestry disability index (odi version 2.1a) at three months (6 - 20 weeks) postoperatively
- M1050Functional status was measured by the oswestry disability index (odi version 2.1a) patient reported outcome tool within three months preoperatively and at three months (6 to 20 weeks) postoperatively
- M1051Patient had cancer, acute fracture or infection related to the lumbar spine or patient had neuromuscular, idiopathic or congenital lumbar scoliosis
- M1052Leg pain was not measured by the visual analog scale (vas) or numeric pain scale at one year (9 to 15 months) postoperatively
- M1053Leg pain was measured by the visual analog scale (vas) within three months preoperatively and at one year (9 to 15 months) postoperatively
- M1054Patient had only urgent care visits during the performance period
- M1055Aspirin or another antiplatelet therapy used
- M1056Prescribed anticoagulant medication during the performance period, history of gi bleeding, history of intracranial bleeding, bleeding disorder and specific provider documented reasons: allergy to aspirin or anti-platelets, use of non-steroidal anti-inflammatory agents, drug-drug interaction, uncontrolled hypertension > 180/110 mmhg or gastroesophageal reflux disease
- M1057Aspirin or another antiplatelet therapy not used, reason not given
- M1058Patient was a permanent nursing home resident at any time during the performance period
- M1059Patient was in hospice or receiving palliative care at any time during the performance period
- M1060Patient died prior to the end of the performance period
- M1061Patient pregnancy
- M1062Patient immunocompromised
- M1063Patients receiving high doses of immunosuppressive therapy
- M1064Shingrix vaccine documented as administered or previously received
- M1065Shingrix vaccine was not administered for reasons documented by clinician (e.g. patient administered vaccine other than shingrix, patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)
- M1066Shingrix vaccine not documented as administered, reason not given
- M1067Hospice services for patient provided any time during the measurement period
- M1068Adults who are not ambulatory
- M1069Patient screened for future fall risk
- M1070Patient not screened for future fall risk, reason not given
- M1071Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy
- M1106The start of an episode of care documented in the medical record
- M1107Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care
- M1108Ongoing care not clinically indicated because the patient needed a home program only, referral to another provider or facility, or consultation only, as documented in the medical record
- M1109Ongoing care not medically possible because the patient was discharged early due to specific medical events, documented in the medical record, such as the patient became hospitalized or scheduled for surgery
- M1110Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)
- M1111The start of an episode of care documented in the medical record
- M1112Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care
- M1113Ongoing care not clinically indicated because the patient needed a home program only, referral to another provider or facility, or consultation only, as documented in the medical record
- M1114Ongoing care not medically possible because the patient was discharged early due to specific medical events, documented in the medical record, such as the patient became hospitalized or scheduled for surgery
- M1115Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)
- M1116The start of an episode of care documented in the medical record