M1430 HCPCS Level II Code: Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)
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
Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year) is a HCPCS Level II code (M1430). CMS assigns coverage code C — Carrier judgment. Short description: Ret exm ou no retinopthy doc.
Nearest Codes in This Family
Official HCPCS Level II classifications closest to M1430 in its code family, with their registry titles.
- M1425 — Surgical care mips value pathway
- M1426 — Encounters conducted via telehealth
- M1427 — Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)
- 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
- M1431 — Encounters conducted via telehealth
- M1432 — Encounters conducted via telehealth
- M1433 — Patient on oral chemotherapy on or within 30 days before denominator eligible encounter
- M1434 — Patient on oral chemotherapy on or within 30 days after denominator eligible encounter
- M1435 — Patient on oral chemotherapy during the performance period