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HCPCS Level II/M-Codes/M1216

M1216 HCPCS Level II Code: No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter

M1216 is the authoritative medical code for No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter. This classification is used in medical billing and clinical recording to specify the clinical criteria for no spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter (HCPCS Level II M1216), ensuring healthcare documentation aligns with current federal coding standards.

Billing Status: Processed within HCPCS Level II standards. CMS regulatory guidelines apply.

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, 2024

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

No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter is a HCPCS Level II code (M1216) for a Medicare-covered supply, service, or procedure. Short description: No spiro doc no res doc.

Nearest Codes in This Family

Official HCPCS Level II classifications closest to M1216 in its code family, with their registry titles.

  • M1211 — Most recent glycemic status assessment (hba1c or gmi) level > 9.0%
  • M1212 — Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period
  • M1213 — No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%
  • M1214 — Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed
  • M1215 — Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)
  • M1217 — Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)
  • M1218 — Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)
  • M1219 — Anaphylaxis due to the vaccine on or before the date of the encounter
  • M1220 — Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy
  • M1221 — Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy