M1196 Ixv nrs vrs iqa >=4
Also known as: baseline symptom score assessment, high symptom burden documented
Initial symptom assessment score or baseline intensity/quality/affect score of 4 or greater on numeric rating scale.
In Plain Language
Moderate to severe initial symptom score; High baseline distress measured
Clinical Context
Palliative and oncology quality measure documenting baseline symptom severity using numeric rating scales to track treatment response and symptom improvement.
RVU Information
CPT M1196 does not have a physician work RVU assigned by CMS. Reimbursement for this code is determined by payer-specific fee schedules.
Billing & Documentation
M-codes cover quality measures and performance reporting. They are used in value-based care programs to track whether specific clinical actions were taken. Documentation must support that the measured action was performed or a valid exclusion applies.
Specialties
Frequently Asked Questions
What is CPT code M1196?
CPT M1196 (Ixv nrs vrs iqa >=4) is a M Codes code. Initial symptom assessment score or baseline intensity/quality/affect score of 4 or greater on numeric rating scale.
Is M1196 covered by insurance?
M1196 is a temporary HCPCS code. Coverage varies by payer and may change when permanent codes are assigned. Palliative and oncology quality measure documenting baseline symptom severity using numeric rating scales to track treatment response and symptom improvement.
When is CPT M1196 used?
Palliative and oncology quality measure documenting baseline symptom severity using numeric rating scales to track treatment response and symptom improvement.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.