Skip to main content
HCPCS Level II/M-Codes/M1238

M1238 HCPCS Level II Code: Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)

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

Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31) is a HCPCS Level II code (M1238) for a Medicare-covered supply, service, or procedure. Short description: Doc 2nd recom hzv 2-6 mo int.

Nearest Codes in This Family

Official HCPCS Level II classifications closest to M1238 in its code family, with their registry titles.

  • 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
  • M1237 — Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)
  • M1239 — Patient did not respond to the question of patient felt heard and understood by this provider and team
  • M1240 — Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care
  • M1241 — Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem
  • M1242 — Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life
  • M1243 — Patient provided a response other than "completely true" for the question of patient felt heard and understood by this provider and team