Summary & Overview
HCPCS Level II M1447: Bipolar Disorder Diagnosis Measure
HCPCS Level II code M1447 designates patients who have an active diagnosis of bipolar disorder at any time prior to the end of a measure assessment period. The code is used for population identification and quality measurement around bipolar disorder diagnosis documentation across ambulatory and behavioral health settings. Nationally, consistent capture of bipolar disorder in claims and reporting systems supports care coordination, quality measurement, and performance benchmarking for mental health services.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find context on the clinical meaning of the code, the typical service settings where it is recorded, and what role the code plays in measurement and reporting. The publication provides benchmarks and policy-relevant perspectives on documentation and coding practices, highlights implications for quality measurement and care management workflows, and summarizes national considerations for payer coverage and reporting strategies.
This summary is intended for a national audience of policy analysts, payers, provider organizations, and quality measurement professionals seeking a concise reference on the purpose and operational context of HCPCS Level II code M1447.
Billing Code Overview
HCPCS Level II code M1447 indicates patients with an active diagnosis of bipolar disorder any time prior to the end of the measure assessment period. This code represents a clinical population identification/diagnosis-related measure used to capture patients with bipolar disorder documented during the measurement interval.
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Service type: Population/diagnosis identification and reporting
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Typical site of service: Behavioral health outpatient settings, primary care offices, and other ambulatory care sites where psychiatric diagnoses are recorded
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Clinical & Coding Specifications
Clinical Context
A 34-year-old patient with a history of mood swings presents to an outpatient behavioral health clinic for routine follow-up. The patient was diagnosed previously with bipolar I disorder during an inpatient psychiatric admission two years ago and continues to receive pharmacotherapy and psychotherapy. During the measurement period, the care team documents the active diagnosis of bipolar disorder in the problem list and progress notes, records ongoing mood-stabilizing medication management, and coordinates care with a psychiatrist. Typical clinical workflow includes: initial chart review to confirm prior diagnoses, structured assessment (PHQ-9, mood charting), medication reconciliation, psychotherapy or psychiatric evaluation visit, and documentation of the active diagnosis in the electronic health record before the end of the measure assessment period. Typical site of service is outpatient behavioral health clinic, community mental health center, or primary care office managing long-term psychiatric conditions. Service type is longitudinal diagnostic management and documentation of an active psychiatric diagnosis for quality reporting and population health measurement.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service on the same day as another procedure | Use when an E/M visit for psychiatric management is distinct from a procedure on the same day |