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HCPCS Level II/M-Codes/M1192

M1192 HCPCS Level II Code: Patients with an existing diagnosis of squamous cell carcinoma of the esophagus

Medicare Coverage & Payment

  • Medicare coverage: Carrier judgment (CMS coverage code C)
  • Payment category: Service not separately priced (pricing indicator 00)
  • BETOS: Z2
  • Effective: January 1, 2023

Source: CMS HCPCS Level II release. Coverage codes indicate how Medicare treats the code, not whether a specific claim will be paid; payer policy and documentation still govern.

Official Registry Overview & Definition

Patients with an existing diagnosis of squamous cell carcinoma of the esophagus is a HCPCS Level II code (M1192). CMS assigns coverage code C — Carrier judgment. Short description: Pt w/ dx sq cell ca of esoph.

Nearest Codes in This Family

Official HCPCS Level II classifications closest to M1192 in its code family, with their registry titles.

  • M1187 — Patients with a diagnosis of end stage renal disease (esrd)
  • M1188 — Patients with a diagnosis of chronic kidney disease (ckd) stage 5
  • M1189 — Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed
  • M1190 — Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)
  • M1191 — Hospice services provided to patient any time during the measurement period
  • M1193 — Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both
  • M1194 — Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therapy, no residual carcinoma is present in the sample [tissue exhausted or status post neoadjuvant treatment], insufficient tumor for testing)
  • M1195 — Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given
  • M1196 — Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4
  • M1197 — Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score