HCPCS Code Details - M1209

HCPCS Level II Code
Medical services
HCPCS Code M1209
Description

Long description:
At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses

Short description:
>=2 same hi-rsk med w/o diag

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 N - No maintenance for this code
Type of service 1 - Medical care
Effective date Effective Jan 01, 2023
Date added Added Jan 01, 2023
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 M1208 · Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety

  • HCPCS G9367 · At least two orders for high-risk medications from the same drug class

  • HCPCS G9368 · At least two orders for high-risk medications from the same drug class not ordered

  • HCPCS M1210 · At least two orders for high-risk medications from the same drug class, (table 4), not ordered


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”