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HCPCS Level II/M-Codes/M1186

M1186 HCPCS Level II Code: Patients who have an order for or are receiving hospice or palliative care

M1186 is the authoritative medical code for Patients who have an order for or are receiving hospice or palliative care. This classification is used in medical billing and clinical recording to specify the clinical criteria for patients who have an order for or are receiving hospice or palliative care (HCPCS Level II M1186), ensuring healthcare documentation aligns with current federal coding standards.

Billing Status: Processed within HCPCS Level II standards. CMS regulatory guidelines apply.

Medicare Coverage & Payment

  • Medicare coverage: Carrier judgment (CMS coverage code C)
  • Payment category: Service not separately priced (pricing indicator 00)
  • BETOS: Z2
  • 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

Patients who have an order for or are receiving hospice or palliative care is a HCPCS Level II code (M1186) for a Medicare-covered supply, service, or procedure. Short description: Pt w/ rx for hspc/plltv care.

Nearest Codes in This Family

Official HCPCS Level II classifications closest to M1186 in its code family, with their registry titles.

  • 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)
  • M1185 — Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given
  • 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)
  • M1191 — Hospice services provided to patient any time during the measurement period