M1405 – Patients with recurrence/disease progression
HCPCS Level II code · M codes: Medical Services and Quality Measures
HCPCS codeM1405
- Long description
- Patients with recurrence/disease progression
- Short description
- Pt w/ recur/prog
- Pricing indicator
00Not separately priced by Part B (bundled, not covered or Part A only)- Medicare coverage
CCarrier judgment – coverage decided by the Medicare contractor- BETOS category
Z2Undefined codes- Added
- January 1, 2025
- Last change
- January 1, 2025 – No change
Frequently asked questions
What is HCPCS code M1405?
M1405 is a HCPCS Level II code for patients with recurrence/disease progression.
Does Medicare cover M1405?
The HCPCS file lists coverage code C: Carrier judgment – coverage decided by the Medicare contractor. Coverage and payment also depend on local coverage determinations and the patient’s plan.
Nearby M codes
- M1397 – Patients with recurrence/disease progression
- M1398 – Patients with baseline and follow-up promis surveys documented in the medical record
- M1399 – Patients who leave the practice during the follow-up period
- M1400 – Patients who died during the follow-up period
- M1401 – Stages i-iii breast cancer
- M1402 – Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group
- M1403 – Patients with baseline and follow-up promis surveys documented in the medical record
- M1404 – Patients on a therapeutic clinical trial
- M1406 – Patients who leave the practice during the follow-up period
- M1407 – Patients who died during the follow-up period
- M1408 – Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer
- M1409 – Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis
- M1410 – Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis
- M1411 – Currently on first-line immune checkpoint inhibitors without chemotherapy
- M1412 – Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skipping mutation, and ret rearrangement
- M1413 – Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy
Source: CMS HCPCS Level II quarterly file, October 2026. Reference only – check payer policy before billing.