M1220 – Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy

Long description

Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy

Short description

Dre wth interp rtnopthy

Pricing indicator

00 Not separately priced by Part B (bundled, not covered or Part A only)

Medicare coverage

C Carrier judgment – coverage decided by the Medicare contractor

BETOS category

Z2 Undefined codes

Added

January 1, 2024

Last change

January 1, 2024 – No change

Nearby M codes

• M1212 – Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period
• M1213 – No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%
• M1214 – Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed
• M1215 – Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)
• M1216 – No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter
• M1217 – Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)
• M1218 – Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)
• M1219 – Anaphylaxis due to the vaccine on or before the date of the encounter
• M1221 – Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy
• M1222 – Glaucoma plan of care not documented, reason not otherwise specified
• M1223 – Glaucoma plan of care documented
• M1224 – Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level
• M1225 – Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level
• M1226 – Iop measurement not documented, reason not otherwise specified
• M1227 – Evidence-based therapy was prescribed
• M1228 – Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test