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M1292 Pt 66+ frail inpt adv ill

M Codes

Also known as: frail elderly hospitalized, senior advanced illness, geriatric acute illness

Patient age 66 and older with documented frailty and inpatient advanced illness. Documents elderly patients with severe functional limitation and complex acute medical conditions.

In Plain Language

very elderly and very sick; frail elderly in hospital

Clinical Context

Geriatric quality measure identifying high-risk older adults with frailty and serious acute illness, often requiring palliative care involvement and advance care planning.

RVU Information

CPT M1292 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

GeriatricsCritical CarePalliative Care

Frequently Asked Questions

What is CPT code M1292?

CPT M1292 (Pt 66+ frail inpt adv ill) is a M Codes code. Patient age 66 and older with documented frailty and inpatient advanced illness. Documents elderly patients with severe functional limitation and complex acute medical conditions.

Is M1292 covered by insurance?

M1292 is a temporary HCPCS code. Coverage varies by payer and may change when permanent codes are assigned. Geriatric quality measure identifying high-risk older adults with frailty and serious acute illness, often requiring palliative care involvement and advance care planning.

When is CPT M1292 used?

Geriatric quality measure identifying high-risk older adults with frailty and serious acute illness, often requiring palliative care involvement and advance care planning.

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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.