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HCPCS Level II/M-Codes/M1231

M1231 HCPCS Level II Code: Patient receives hcv antibody test with nonreactive result

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

Patient receives hcv antibody test with nonreactive result is a HCPCS Level II code (M1231). CMS assigns coverage code C — Carrier judgment. Short description: Pt hcv tst no reactive res.

Nearest Codes in This Family

Official HCPCS Level II classifications closest to M1231 in its code family, with their registry titles.

  • M1226 — Iop measurement not documented, reason not otherwise specified
  • 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
  • M1232 — Patient receives hcv antibody test with reactive result
  • M1233 — Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given
  • M1234 — Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia
  • M1235 — Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period
  • M1236 — Baseline mrs > 2