HCPCS Code Details - M1211

HCPCS Level II Code
Medical services
HCPCS Code M1211
Description

Long description:
Most recent hemoglobin a1c level > 9.0%

Short description:
Hemoglobin a1c level >9.0%

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, 2024
Date added Added Jan 01, 2024
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 M1210 · At least two orders for high-risk medications from the same drug class, (table 4), not ordered

  • HCPCS G0908 · Most recent hemoglobin (hgb) level > 12.0 g/dl

  • HCPCS G0910 · Most recent hemoglobin level <= 12.0 g/dl

  • HCPCS G2089 · Most recent hemoglobin a1c (hba1c) level 7.0 to 9.0%

  • HCPCS G8973 · Most recent hemoglobin (hgb) level < 10 g/dl

  • HCPCS G8976 · Most recent hemoglobin (hgb) level >= 10 g/dl

  • HCPCS M1212 · Hemoglobin a1c level is missing, or was not performed during the measurement period (12 months)


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”