M1229 – Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection

Long description

Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection

Short description

Pt w/ +hcv +vir ref win 1 mo

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

• 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
• M1230 – Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment initiated within 3 months of the reactive hcv antibody test, reason not given
• M1231 – Patient receives hcv antibody test with nonreactive result
• M1232 – Patient receives hcv antibody test with reactive result
• M1233 – Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given
• M1234 – Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia
• M1235 – Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period
• M1236 – Baseline mrs > 2
• M1237 – Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)