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M1185 HCPCS Level II Code: Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given

Medicare Coverage & Payment

  • CMS short descriptor: Imm ckpt inhib not hld no rx
  • 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 immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given is a HCPCS Level II code (M1185). CMS assigns coverage code C — Carrier judgment. Short description: Imm ckpt inhib not hld no rx.

Change history

  • 2023-01-01
    Added to the code set
    Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given

Contextual Map

Every relationship of M1185 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Nearest codes (40)

  • M1159 — Hospice services provided to patient any time during the measurement period [Sibling]
  • M1160 — Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patient's 13th birthday [Sibling]
  • M1161 — Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patient's 13th birthday [Sibling]
  • M1162 — Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patient's 13th birthday [Sibling]
  • M1163 — Patient had anaphylaxis due to the hpv vaccine any time on or before the patient's 13th birthday [Sibling]
  • M1164 — Patients with dementia any time during the patient's history through the end of the measurement period [Sibling]
  • M1165 — Patients who use hospice services any time during the measurement period [Sibling]
  • M1166 — Pathology report for tissue specimens produced from wide local excisions or re-excisions [Sibling]
  • and 32 more

Change history

  • 2023-01-01 — Added to the code set [Change history]

Nearest Codes in This Family

Official HCPCS Level II classifications closest to M1185 in its code family, with their registry titles.

  • 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
  • M1184 — 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)
  • 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
  • M1190 — Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)