M1211 Gsa level>9.0%
Also known as: elevated HbA1c, poor glycemic control
Patient has glycated hemoglobin (HbA1c) level greater than 9.0 percent.
In Plain Language
Diabetes blood sugar control not good; High long-term blood sugar level
Clinical Context
Quality measure stratifier identifying diabetic patients with suboptimal glycemic control indicating need for treatment intensification or patient education.
RVU Information
CPT M1211 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 M1211?
CPT M1211 (Gsa level>9.0%) is a M Codes code. Patient has glycated hemoglobin (HbA1c) level greater than 9.0 percent.
Is M1211 covered by insurance?
M1211 is a temporary HCPCS code. Coverage varies by payer and may change when permanent codes are assigned. Quality measure stratifier identifying diabetic patients with suboptimal glycemic control indicating need for treatment intensification or patient education.
When is CPT M1211 used?
Quality measure stratifier identifying diabetic patients with suboptimal glycemic control indicating need for treatment intensification or patient education.
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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.