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HCPCS Level II/M-Codes/M1326

M1326 HCPCS Level II Code: Patients with a diagnosis of hypotony

M1326 is the authoritative medical code for Patients with a diagnosis of hypotony. This classification is used in medical billing and clinical recording to specify the clinical criteria for patients with a diagnosis of hypotony (HCPCS Level II M1326), ensuring healthcare documentation aligns with current federal coding standards.

Billing Status: Processed within HCPCS Level II standards. CMS regulatory guidelines apply.

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

Patients with a diagnosis of hypotony is a HCPCS Level II code (M1326) for a Medicare-covered supply, service, or procedure. Short description: Pts dx hypotony.

Nearest Codes in This Family

Official HCPCS Level II classifications closest to M1326 in its code family, with their registry titles.

  • M1321 — 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
  • 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)
  • M1327 — Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks
  • M1328 — Patients with a diagnosis of acute vitreous hemorrhage
  • M1329 — Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter
  • M1330 — Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)
  • M1331 — Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam