M1397 HCPCS Level II Code: Patients with recurrence/disease progression
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
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Medicare Coverage & Payment
- CMS short descriptor: Pt w/ recur/prog
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 M1397 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)
- M1358 — Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment[Sibling]— CMS HCPCS Level II code set
- M1359 — Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained[Sibling]— CMS HCPCS Level II code set
- M1360 — Suicidal ideation and/or behavior symptoms based on the c-ssrs[Sibling]— CMS HCPCS Level II code set
- M1361 — Suicide risk based on their clinician's evaluation or a clinician-rated tool[Sibling]— CMS HCPCS Level II code set
- M1362 — Patients who died during the measurement period[Sibling]— CMS HCPCS Level II code set
- M1363 — Patients who did not have a follow-up assessment within 120 days of the index assessment[Sibling]— CMS HCPCS Level II code set
- M1364 — Calculated 10-year ascvd risk score of >= 20 percent during the performance period[Sibling]— CMS HCPCS Level II code set
- M1365 — Patient encounter during the performance period with hospice and palliative care specialty code 17[Sibling]— CMS HCPCS Level II code set
- and 32 more
Change history
- January 1, 2025 — 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 20, 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. "M1397 — Patients with recurrence/disease progression." HCPCS Level II October 2026. https://medcoder.ai/hcpcs/code/m1397-patients-with-recurrencedisease-progression
Change history
- January 1, 2025Added to the code setPatients with recurrence/disease progressionHCPCS 2025 changes
Nearest Codes in This Family
Official HCPCS Level II classifications closest to M1397 in its code family, with their registry titles.
- M1388 — Patients with documentation of an exam performed for recurrence of melanoma
- M1390 — Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period
- M1391 — All patients who were diagnosed with recurrent melanoma during the current performance period
- M1392 — Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by…
- M1393 — Patients who were not diagnosed with recurrent melanoma during the current performance period
- M1394 — Stages i-iii breast cancer
- M1395 — Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group
- M1396 — Patients on a therapeutic clinical trial
- M1398 — Patients with baseline and follow-up promis surveys documented in the medical record
- M1399 — Patients who leave the practice during the follow-up period