M1275 Pts hosp exl
Also known as: hospitalized ESRD, acute inpatient, hospital exclusion
Patient with hospital exclusion documentation. Records ESRD patients who are ineligible for certain quality measures due to acute hospitalization or hospital-level care requirements.
In Plain Language
hospital patient; inpatient care
Clinical Context
Used to identify and exclude patients from outpatient-specific quality measures when they are receiving active inpatient hospital care.
RVU Information
CPT M1275 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 M1275?
CPT M1275 (Pts hosp exl) is a M Codes code. Patient with hospital exclusion documentation. Records ESRD patients who are ineligible for certain quality measures due to acute hospitalization or hospital-level care requirements.
Is M1275 covered by insurance?
M1275 is a temporary HCPCS code. Coverage varies by payer and may change when permanent codes are assigned. Used to identify and exclude patients from outpatient-specific quality measures when they are receiving active inpatient hospital care.
When is CPT M1275 used?
Used to identify and exclude patients from outpatient-specific quality measures when they are receiving active inpatient hospital care.
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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.