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HCPCS Level II/M-Codes/M1427

M1427 HCPCS Level II Code: Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)

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, 2026

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 medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons) is a HCPCS Level II code (M1427) for a Medicare-covered supply, service, or procedure. Short description: Doc med rsn bone scn.

Nearest Codes in This Family

Official HCPCS Level II classifications closest to M1427 in its code family, with their registry titles.

  • M1422 — Gastroenterology care mips value pathway
  • M1423 — Optimal care for patients with urologic conditions mips value pathway
  • M1424 — Pulmonology care mips value pathway
  • M1425 — Surgical care mips value pathway
  • M1426 — Encounters conducted via telehealth
  • M1428 — Patients who have bilateral absence of eyes any time during the patient's history through the end of the measurement period
  • M1429 — Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented
  • M1430 — Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)
  • M1431 — Encounters conducted via telehealth
  • M1432 — Encounters conducted via telehealth