Skip to main content
HCPCS Level II/M-Codes/M1226

M1226 HCPCS Level II Code: Iop measurement not documented, reason not otherwise specified

Medicare Coverage & Payment

  • Medicare coverage: Carrier judgment (CMS coverage code C)
  • Payment category: Service not separately priced (pricing indicator 00)
  • BETOS: Z2 — Undefined codes
  • Last CMS action 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

Iop measurement not documented, reason not otherwise specified is a HCPCS Level II code (M1226). CMS assigns coverage code C — Carrier judgment. Short description: Iop not doc.

Change history

  • 2024-01-01
    Added to the code set
    Iop measurement not documented, reason not otherwise specified

Nearest Codes in This Family

Official HCPCS Level II classifications closest to M1226 in its code family, with their registry titles.

  • M1221 — Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy
  • M1222 — Glaucoma plan of care not documented, reason not otherwise specified
  • M1223 — Glaucoma plan of care documented
  • M1224 — Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level
  • M1225 — Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level
  • M1227 — Evidence-based therapy was prescribed
  • M1228 — Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test
  • M1229 — Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection
  • M1230 — Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment initiated within 3 months of the reactive hcv antibody test, reason not given
  • M1231 — Patient receives hcv antibody test with nonreactive result