HCPCS Code Details - M1036

HCPCS Level II Code
Medical services
HCPCS Code M1036
Description

Long description:
Adults who have not had at least 180 days of continuous pharmacotherapy with a medication prescribed for oud without a gap of more than seven days

Short description:
Adt no 180 dys pharmthry oud

HCPCS Modifier1
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 A - Add procedure or modifier code
Type of service 1 - Medical care
Effective date Effective Jan 01, 2019
Date added Added Jan 01, 2019
HCPCS Coding Procedures

HCPCS Modifiers

In HCPCS Level II, modifiers are composed of two alpha or alphanumeric characters.

Example: E0260-NU - Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress
NU” identifies the hospital bed as new equipment

See also

  • HCPCS M1035 · Adults who are deliberately phased out of medication assisted treatment (mat) prior to 180 days of continuous treatment

  • HCPCS M1034 · Adults who have at least 180 days of continuous pharmacotherapy with a medication prescribed for oud without a gap of more than seven days

  • HCPCS M1037 · Patients with a diagnosis of lumbar spine region cancer at the time of the procedure


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”