HCPCS Code Details - M1238

HCPCS Level II Code
Medical services
HCPCS Code M1238

Long description:
Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)

Short description:
Doc 2nd recom hzv 2-6 mo int

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 M1237 · Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)

  • HCPCS G8630 · Documentation that administration of prophylactic parenteral antibiotics was initiated within one hour (if fluoroquinolone or vancomycin, two hours) prior to surgical incision (or start of procedure when no incision is required), as ordered

  • HCPCS M1239 · Patient did not respond to the question of patient felt heard and understood by this provider and team

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”