M1260 HCPCS Level II Code: Patient status not documented within the first year of initiating dialysis
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, 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 not documented within the first year of initiating dialysis is a HCPCS Level II code (M1260) for a Medicare-covered supply, service, or procedure. Short description: Pt not doc <= 1 yr dialysis.
Nearest Codes in This Family
Official HCPCS Level II classifications closest to M1260 in its code family, with their registry titles.
- 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
- M1259 — Patient status 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
- M1265 — Cms medical evidence form 2728 for dialysis patients: initial form completed