HCPCS Code Details - M1376

HCPCS Level II Code
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 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, 2025
Date added Added Jan 01, 2025
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 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”