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HCPCS Level II/M-Codes/M1284

M1284 HCPCS Level II Code: Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period

M1284 is the authoritative medical code for Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period. This classification is used in medical billing and clinical recording to specify the clinical criteria for patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period (HCPCS Level II M1284), 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, 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 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period is a HCPCS Level II code (M1284) for a Medicare-covered supply, service, or procedure. Short description: Pt 66+ snp or ltc pos > 90d.

Nearest Codes in This Family

Official HCPCS Level II classifications closest to M1284 in its code family, with their registry titles.

  • M1279 — Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given
  • M1280 — Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy
  • M1281 — Blood pressure reading not documented, reason not given
  • M1282 — Patient screened for tobacco use and identified as a tobacco non-user
  • M1283 — Patient screened for tobacco use and identified as a tobacco user
  • M1285 — Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified
  • M1286 — Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason
  • M1287 — Bmi is documented below normal parameters and a follow-up plan is documented
  • M1288 — Documented reason for not screening or recommending a follow-up for high blood pressure
  • M1289 — Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)