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HCPCS Level II/M-Codes/M1321

M1321 HCPCS Level II Code: Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg

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

Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg is a HCPCS Level II code (M1321). CMS assigns coverage code C — Carrier judgment. Short description: Pts no 7wk inj,no iop,iop>25.

Nearest Codes in This Family

Official HCPCS Level II classifications closest to M1321 in its code family, with their registry titles.

  • M1316 — Current tobacco non-user
  • M1317 — Patients who are counseled on connection with a csp and explicitly opt out
  • M1318 — Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp
  • M1319 — Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening
  • M1320 — Patients who screened positive for at least 1 of the 5 hrsns
  • M1322 — Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye
  • M1323 — Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented
  • M1324 — Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)
  • M1325 — Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within seven (7) weeks of treatment)
  • M1326 — Patients with a diagnosis of hypotony