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HCPCS Level II/M-Codes/M1264

M1264 HCPCS Level II Code: Patients age 75 or older on their initiation of dialysis date

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, 2025
  • Terminated: December 31, 2024

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 age 75 or older on their initiation of dialysis date is a HCPCS Level II code (M1264). CMS assigns coverage code C — Carrier judgment. CMS terminated this code effective December 31, 2024; it cannot be reported for later dates of service. Short description: Pts 75+ dialysis dt.

Nearest Codes in This Family

Official HCPCS Level II classifications closest to M1264 in its code family, with their registry titles.

  • M1259 — Patient status documented within the first year of initiating dialysis
  • 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
  • M1265 — Cms medical evidence form 2728 for dialysis patients: initial form completed
  • M1266 — Patients admitted to a skilled nursing facility (snf)
  • M1267 — Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period
  • M1268 — Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period
  • M1269 — Receiving esrd mcp dialysis services by the provider on the last day of the reporting month