M1243 HCPCS Level II Code: Patient provided a response other than "completely true" for the question of patient felt heard and understood by this provider and team
HCPCS Level II code, maintained by CMS. Not a CPT code: CPT (HCPCS Level I) is a separate AMA code set that MedCoder does not publish. About HCPCS Level II
Compare with another code for M1243Check this code on a claim
Code status: Valid code · October 2026. A valid code in the CMS HCPCS Level II October 2026 file. Valid is not covered or payable: Medicare payment and coverage are shown below in CMS’s own terms.
Medicare Coverage & Payment
- CMS short descriptor: Pt othr thn true heard
- 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.
Coding context
Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.
Contextual Map
Every relationship of M1243 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.
Nearest codes (40)
- M1223 — Glaucoma plan of care documented[Sibling]— CMS HCPCS Level II code set
- M1224 — Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level[Sibling]— CMS HCPCS Level II code set
- M1225 — Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level[Sibling]— CMS HCPCS Level II code set
- M1226 — Iop measurement not documented, reason not otherwise specified[Sibling]— CMS HCPCS Level II code set
- M1227 — Evidence-based therapy was prescribed[Sibling]— CMS HCPCS Level II code set
- 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[Sibling]— CMS HCPCS Level II code set
- 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[Sibling]— CMS HCPCS Level II code set
- 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[Sibling]— CMS HCPCS Level II code set
- and 32 more
Change history
- January 1, 2024 — Added to the code set [Change history]— CMS release files (code change ledger)
Reference
Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.
Sources for this page
Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.
- Code, descriptors, coverage and pricing attributes Official source data
- CMS HCPCS Alpha-Numeric (ANWEB) release — October 2026 quarterly update Release, file and checksum · Publisher’s page
- Change history and date-of-service validity Official source data
- CMS HCPCS quarterly update files, ingested into the change ledger Release, file and checksum · Publisher’s page
- Comparisons, relationships and the contextual map MedCoder-derived relationship
- Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
- Summary and FAQ answers MedCoder editorial explanation
- Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.
Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources
Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules
Cite this page
Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.
MedCoder.ai. "M1243 — Patient provided a response other than "completely true" for the question of patient felt heard and understood by this provider and team." HCPCS Level II October 2026. https://medcoder.ai/hcpcs/code/m1243-patient-provided-a-response-other-than-completely-true-for-the
Change history
- January 1, 2024Added to the code setPatient provided a response other than "completely true" for the question of patient felt heard and understood by this provider and teamHCPCS 2024 changes
Nearest Codes in This Family
Official HCPCS Level II classifications closest to M1243 in its code family, with their registry titles.
- M1238 — 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…
- 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
- M1244 — Patient provided a response other than "completely true" for the question of patient felt this provider and team put my best interests first when making recommendations about my care
- M1245 — Patient provided a response other than "completely true" for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem
- M1246 — Patient provided a response other than "completely true" for the question of patient felt this provider and team understood what is important to me in my life
- M1247 — Patient responded "completely true" for the question of patient felt this provider and team put my best interests first when making recommendations about my care
- M1248 — Patient responded "completely true" for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem