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HCPCS Level II/M-Codes/M1330

M1330 HCPCS Level II Code: Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)

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

Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up) is a HCPCS Level II code (M1330). CMS assigns coverage code C — Carrier judgment. Short description: Doc pts rsn no f/u xm.

Nearest Codes in This Family

Official HCPCS Level II classifications closest to M1330 in its code family, with their registry titles.

  • 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
  • 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
  • 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
  • M1334 — Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter
  • M1335 — Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)