M1206 Isa not red 3pts/no assess
Also known as: inadequate symptom improvement, persistent symptoms
Symptom intensity or quality or affect score not reduced by 3 or more points or assessment not performed.
In Plain Language
Symptoms did not improve much; Inadequate pain or symptom control
Clinical Context
Quality measure denominator for palliative care cases with inadequate symptom control or missing reassessment.
RVU Information
CPT M1206 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 M1206?
CPT M1206 (Isa not red 3pts/no assess) is a M Codes code. Symptom intensity or quality or affect score not reduced by 3 or more points or assessment not performed.
Is M1206 covered by insurance?
M1206 is a temporary HCPCS code. Coverage varies by payer and may change when permanent codes are assigned. Quality measure denominator for palliative care cases with inadequate symptom control or missing reassessment.
When is CPT M1206 used?
Quality measure denominator for palliative care cases with inadequate symptom control or missing reassessment.
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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.