HCPCS Code M1376

An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period
Code effective Jan 01, 2025

HCPCS Section
Medical services

M1376 is a valid 2026 HCPCS code meaning An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period or (Ra dx enc 90 days dur per pd) for short. HCPCS M1376 has been effective since 01/01/2025 and applies to Medical care.

HCPCS Code Details - M1376

HCPCS Level II Code
Section M - Medical services
HCPCS Code M1376
Description

Long description:
An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period

Short description:
Ra dx enc 90 days dur per pd

HCPCS Pricing indicator 00 - Physician Fee Schedule And Non-Physician Practitioners - Service not separately priced by part B (e.g., services not covered, bundled, used by Part A only, etc.)
Multiple pricing indicator 9 - Not applicable as HCPCS not priced separately by part B or value is not established
Coverage code C - Carrier judgment
BETOS2 code Z2 - Undefined codes
HCPCS Action code N - No maintenance for this code
Type of service 1 - Medical care
Effective date Effective Jan 01, 2025
Date added Added Jan 01, 2025

See also

  • HCPCS M1374 · An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period

  • HCPCS M1375 · An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period

  • HCPCS M1377 · Recommended follow-up interval for repeat colonoscopy of 10 years documented in colonoscopy report and communicated with patient

1 Two-digit numeric codes are Level I code modifiers copyrighted© by the American Medical Association's Current Procedural Terminology (CPT).

2 BETOS stands for “Berenson-Eggers Type Of Service”

HCPCS Level II codes and descriptors are approved and maintained jointly by the alpha-numeric editorial panel (consisting of CMS, the Health Insurance Association of America, and the Blue Cross and Blue Shield Association). — Updated 6/24/2026

CPT® is a registered trademark of the American Medical Association (AMA). All rights reserved.