M1328 HCPCS Level II Code: Patients with a diagnosis of acute vitreous hemorrhage
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 acute vitreous hemorrhage is a HCPCS Level II code (M1328). CMS assigns coverage code C — Carrier judgment. Short description: Pts dx acute vitreous hem.
Nearest Codes in This Family
Official HCPCS Level II classifications closest to M1328 in its code family, with their registry titles.
- 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
- M1327 — Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks
- 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
- M1332 — Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks
- M1333 — Acute vitreous hemorrhage