M1259 HCPCS Level II code: Patient status documented within the first year of initiating dialysis
M1259 is the HCPCS code for “Patient status documented within the first year of initiating dialysis” in CMS’s October 2026 release, in effect from Oct 1, 2026.
Official description
M1259Patient status documented within the first year of initiating dialysis
Short description: Pt stat doc <= 1 yr dialysis
HCPCS · United States
Medicare details
The indicators CMS publishes with M1259 in its October 2026 file. They describe Medicare’s handling, not another payer’s.
- Medicare coverage
- Carrier judgment
- Medicare pricing
- Service not separately priced by Part B (e.g., services not covered, bundled, used by Part A only, etc.)
- Type of service
- Medical care
- BETOS category
- Undefined codes
- Added
- Jan 1, 2024
Where M1259 sits
- 1M codesMedical services and quality measures
- 2Active code M1259Patient status documented within the first year of initiating dialysis
Source and release
- Data release
- HCPCS Level II · October 2026
- Effective date
- Oct 1, 2026
- Publisher
- CMS
This page is built from the HCPCS Level II catalog that Vero Codes reads when it suggests codes: Centers for Medicare & Medicaid Services’s October 2026 release, imported from the publisher’s file and checked against it. The description, notes and structured data come from the same record.
Frequently asked questions
What does HCPCS code M1259 mean?
M1259 is the HCPCS code for “Patient status documented within the first year of initiating dialysis” in CMS’s HCPCS Level II October 2026 release.
Does Medicare cover M1259?
CMS lists M1259’s Medicare coverage as “Carrier judgment” and its pricing as “Service not separately priced by Part B (e.g., services not covered, bundled, used by Part A only, etc.)”. Coverage and payment still depend on the patient, the setting, the documentation and the payer.
Which HCPCS Level II release does this page use?
It uses CMS’s October 2026 release, in effect from Oct 1, 2026 to Dec 31, 2026. It is a reference: confirm the code against the current list and the payer’s rules before you submit it.
Codes beside M1259
All M codesM1253Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)M1254Patients who were deceased when the hu survey reached themM1255Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob…M1256Prior history of known cvdM1257Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specifiedM1258Cvd risk assessment performed, have a documented calculated risk scoreM1260Patient status not documented within the first year of initiating dialysisM1261Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysisM1262Patients who had a transplant prior to initiation of dialysisM1263Patients in hospice on their initiation of dialysis date or during the month of evaluationM1264Patients age 75 or older on their initiation of dialysis dateM1265Cms medical evidence form 2728 for dialysis patients: initial form completed