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M1259 HCPCS Level II Code: Patient status documented within the first year of initiating dialysis

Medicare Coverage & Payment

  • CMS short descriptor: Pt stat doc <= 1 yr dialysis
  • 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, 2025

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

Patient status documented within the first year of initiating dialysis is a HCPCS Level II code (M1259). CMS assigns coverage code C — Carrier judgment. Short description: Pt stat doc <= 1 yr dialysis.

Change history

  • 2024-01-01
    Added to the code set
    Patient status documented within the first year of initiating dialysis

Contextual Map

Every relationship of M1259 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)

  • M1239 — Patient did not respond to the question of patient felt heard and understood by this provider and team [Sibling]
  • M1240 — Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care [Sibling]
  • M1241 — Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem [Sibling]
  • M1242 — Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life [Sibling]
  • M1243 — Patient provided a response other than "completely true" for the question of patient felt heard and understood by this provider and team [Sibling]
  • M1244 — Patient provided a response other than "completely true" for the question of patient felt this provider and team put my best interests first when making recommendations about my care [Sibling]
  • M1245 — Patient provided a response other than "completely true" for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem [Sibling]
  • M1246 — Patient provided a response other than "completely true" for the question of patient felt this provider and team understood what is important to me in my life [Sibling]
  • and 32 more

Change history

  • 2024-01-01 — Added to the code set [Change history]

Nearest Codes in This Family

Official HCPCS Level II classifications closest to M1259 in its code family, with their registry titles.

  • M1254 — Patients who were deceased when the hu survey reached them
  • M1255 — Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)
  • M1256 — Prior history of known cvd
  • M1257 — Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified
  • M1258 — Cvd risk assessment performed, have a documented calculated risk score
  • M1260 — Patient status not documented within the first year of initiating dialysis
  • M1261 — Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis
  • M1262 — Patients who had a transplant prior to initiation of dialysis
  • M1263 — Patients in hospice on their initiation of dialysis date or during the month of evaluation
  • M1264 — Patients age 75 or older on their initiation of dialysis date