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    v1.0.30
    OpenPayerBilling CodesOtherHCPCS hcpcs-m1000-pain-screen-moderate-severe
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    HCPCS M1000: Pain Screened as Moderate to Severe

    HCPCS Level II code M1000 indicates that a patient's pain was screened and documented as moderate to severe, representing a pain assessment service typically performed as a screening/assessment during clinical encounters such as office visits, outpatient clinics, or emergency department evaluations where pain severity is evaluated and recorded for clinical management and care planning.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 58-year-old patient with a history of metastatic breast cancer presents to an oncology infusion clinic reporting new or worsening pain that interferes with activities of daily living. Nursing staff perform a standardized pain screen during triage and document the pain as moderate to severe based on a validated pain scale (e.g., 4–10/10) and associated functional impact. The clinical workflow includes: initial triage and pain screening by nursing; review by the treating clinician (medical oncologist, palliative care physician, or pain specialist); assessment of potential causes (disease progression, treatment-related neuropathy, bone metastasis, procedural pain); adjustment of analgesic plan (starting or increasing opioids, adding adjuvants such as neuropathic agents, or arranging interventional pain procedures); and scheduling of follow-up within an appropriate interval. Billing staff assign the HCPCS Level II code M1000 to denote that pain was screened and classified as moderate to severe during the encounter, supporting clinical decisions and downstream care coordination such as symptom management referrals, prescription changes, or pain clinic consults.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    99213Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutesCommon E/M code used when a clinician assesses moderate-to-severe pain and adjusts treatment during an outpatient visit
    99214Office or other outpatient visit for the evaluation and management of an established patient, typically 25 minutesUsed when the pain assessment is more complex and requires moderate to high medical decision making or extended counseling
    99221Initial hospital inpatient care, typically 30 minutesApplied when inpatient evaluation of moderate-to-severe pain is performed on admission and documented accordingly
    99406Smoking and tobacco use cessation counseling visit, intermediate, 3–10 minutesOften performed in comprehensive symptom management visits; may co-occur but not specific to pain screening
    94640Pressurized or non-pressurized inhalation treatment for acute respiratory symptomsNot specific to pain screening; included only if respiratory symptom management occurs alongside pain care

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    25CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    24Modifier 24 denotes an unrelated evaluation and management (E/M) service performed by the same physician or qualified healthcare professional during a postoperative global period. Per CPT guidance,…- Use modifier 24 when you report an evaluation and management (E/M) service performed by the same physician or same-specialty group during a procedure’s postoperative global period that is unrelated…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    77Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…
    91Modifier 91 — “Repeat Clinical Diagnostic Laboratory Test” — is appended when the exact same CPT laboratory test is performed more than once for the same patient on the same day because serial,…- Use modifier 91 when the exact same CPT laboratory test is performed more than once on the same patient on the same date because serial or repeated testing is medically necessary to monitor…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207RH0000X
    208D00000X
    213E00000X
    363L00000X
    246ZB0301X
    207VG0400X
    103TB0200X
    207PP0204X

    Related ICD-10-CM Codes

    23 rows

    ICD-10-CM CodeDescription
    F41.9Anxiety disorder, unspecified
    F45.41Pain disorder exclusively related to psychological factors
    G43.909Migraine, unspecified, not intractable, without status migrainosus
    G89.0Central pain syndrome
    G90.9Disorder of the autonomic nervous system, unspecified
    M17.11Unilateral primary osteoarthritis, right knee
    M17.12Unilateral primary osteoarthritis, left knee
    M19.071Primary osteoarthritis, right ankle and foot
    M19.072Primary osteoarthritis, left ankle and foot
    M25.561Pain in right knee

    Showing 1–10 of 23

    Related Codes

    HCPCS-C1300-HYPERBARIC-OXYGEN-FULL-BODY-CHAMBER-30MIN

    HCPCS Level II C1300: Hyperbaric Oxygen, Full‑Body Chamber, per 30 min

    HCPCS-K0901-KNEE-ORTHOSIS-SINGLE-UPRIGHT-PREFABRICATED

    HCPCS Level II K0901: Knee Orthosis, Single Upright, Prefabricated

    HCPCS-K0902-KNEE-ORTHOSIS-DOUBLE-UPRIGHT-PREFABRICATED-OTS

    HCPCS Level II K0902: Knee Orthosis, Double Upright, Prefabricated

    HCPCS-K0903-DIABETIC-CUSTOM-MULTIPLE-DENSITY-INSERT

    HCPCS K0903: Diabetic Custom Multi-density Total Contact Insert

    HCPCS-K1001-ELECTRONIC-POSITIONAL-OSA-TREATMENT-SENSOR

    HCPCS K1001: Electronic Positional Obstructive Sleep Apnea Treatment

    HCPCS-K1002-CRANIAL-ELECTROTHERAPY-STIMULATION-SYSTEM

    HCPCS K1002: Cranial Electrotherapy Stimulation System

    HCPCS-K1003-WHIRLPOOL-TUB-WALK-IN-PORTABLE

    HCPCS Level II K1003: Whirlpool Tub, Walk-In, Portable

    HCPCS-LEVEL-II-M1144-LIMITED-CONSULTATIVE-THERAPY-1-2-VISITS

    HCPCS Level II M1144: Ongoing Care Not Indicated, 1–2 Visits

    HCPCS-M0064-PSYCHIATRIC-MEDICATION-MANAGEMENT-BRIEF-OFFICE-VISIT

    HCPCS M0064: Brief Visit for Psychiatric Medication Monitoring

    HCPCS-M1001-PAIN-MANAGEMENT-PLAN-OF-CARE-MODERATE-SEVERE-PAIN

    HCPCS Level II M1001: Plan of Care for Moderate to Severe Pain

    Showing 1–10 of 16

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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