M1323 – Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented

Long description

Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented

Short description

Pts 7wk inj, scrn iop >25

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

• M1315 – Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified
• M1316 – Current tobacco non-user
• M1317 – Patients who are counseled on connection with a csp and explicitly opt out
• M1318 – Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp
• M1319 – Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening
• M1320 – Patients who screened positive for at least 1 of the 5 hrsns
• M1321 – Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg
• M1322 – Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye
• M1324 – Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)
• M1325 – Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within seven (7) weeks of treatment)
• M1326 – Patients with a diagnosis of hypotony
• M1327 – Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks
• M1328 – Patients with a diagnosis of acute vitreous hemorrhage
• M1329 – Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter
• M1330 – Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)
• M1331 – Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam