M1184 HCPCS Level II Code: Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting diagnostic workup results for alternative etiologies, other medical reasons/contraindication)
Medicare Coverage & Payment
- Medicare coverage: Carrier judgment (CMS coverage code C)
- Payment category: Service not separately priced (pricing indicator 00)
- BETOS: Z2 — Undefined codes
- Last CMS action effective: January 1, 2023
Source: CMS HCPCS Level II release. Coverage codes indicate how Medicare treats the code, not whether a specific claim will be paid; payer policy and documentation still govern.
Official Registry Overview & Definition
Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting diagnostic workup results for alternative etiologies, other medical reasons/contraindication) is a HCPCS Level II code (M1184). CMS assigns coverage code C — Carrier judgment. Short description: Doc med rsn no cst/ist rx.
Change history
- 2023-01-01Added to the code setDocumentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting diagnostic workup results for alternative etiologies, other medical reasons/contraindication)
Nearest Codes in This Family
Official HCPCS Level II classifications closest to M1184 in its code family, with their registry titles.
- M1179 — Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period
- M1180 — Patients on immune checkpoint inhibitor therapy
- M1181 — Grade 2 or above diarrhea and/or grade 2 or above colitis
- M1182 — Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohn's disease)
- M1183 — Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered
- M1185 — Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given
- M1186 — Patients who have an order for or are receiving hospice or palliative care
- M1187 — Patients with a diagnosis of end stage renal disease (esrd)
- M1188 — Patients with a diagnosis of chronic kidney disease (ckd) stage 5
- M1189 — Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed