M1056 HCPCS - PRESCRIBED ANTICOAGULANT MEDICATION DURING THE PERFORMANCE PERIOD, HISTORY OF GI BLEEDING, HISTORY OF INTRACRANIAL BLEEDING, BLEEDING DISORDER AND SPECIFIC PROVIDER DOCUMENTED REASONS: ALLERGY TO ASPIRIN OR ANTI-PLATELETS, USE OF NON-STEROIDAL ANTI-INFLAMMATORY AGENTS, DRUG-DRUG INTERACTION, UNCONTROLLED HYPERTENSION > 180/110 MMHG OR GASTROESOPHAGEAL REFLUX DISEASE

Code Information

  • HCPCS Code: M1056
  • Sequence Number: 0010
  • Short Description: Presc antico med in pp
  • Long Description: Prescribed anticoagulant medication during the performance period, history of gi bleeding, history of intracranial bleeding, bleeding disorder and specific provider documented reasons: allergy to aspirin or anti-platelets, use of non-steroidal anti-inflammatory agents, drug-drug interaction, uncontrolled hypertension > 180/110 mmhg or gastroesophageal reflux disease
  • Date Added: 1/1/2019
  • Action Code: N - No maintenance for this code
  • Action Effective Date: 1/1/2019
  • Classification: Medical Services
  • Coding System: HCPCS

Code Type

  • Berenson-Eggers Type Of Service Code: Z2 - Undefined codes
  • Type Of Service Code:
    • 1 - Whole blood only eff 01/96, whole blood or packed red cells before 01/96

Billing Information

  • Pricing Indicator Code:
    • 00 - Service not separately priced by part B (e.G., services not covered, bundled, used by part a only, etc.)
  • Multiple Pricing Indicator Code: 9 - Not applicable as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99')
  • Coverage Issues Manual Reference Section Number:
      N/A
    • Medicare Carriers Manual Reference Section Number:
        N/A
      • Coverage Code: C - Carrier judgment

      HCPCS Record

      Field Name Field Value
      Healthcare Common Procedure Coding System Code M1056
      HCPCS Sequence Number 0010
      HCPCS Record Identification Code 3 - First line of procedure record also contains detail information in positions 92-275
      HCPCS Long Description Prescribed anticoagulant medication during the performance period, history of gi bleeding, history of intracranial bleeding, bleeding disorder and specific provider documented reasons: allergy to aspirin or anti-platelets, use of non-steroidal anti-inflammatory agents, drug-drug interaction, uncontrolled hypertension > 180/110 mmhg or gastroesophageal reflux disease
      HCPCS Short Description Presc antico med in pp
      HCPCS Pricing Indicator Code 1 00 - Service not separately priced by part B (e.G., services not covered, bundled, used by part a only, etc.)
      HCPCS Multiple Pricing Indicator Code 9 - Not applicable as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99')
      HCPCS Coverage Code C - Carrier judgment
      HCPCS Berenson-Eggers Type Of Service Code Z2 - Undefined codes
      HCPCS Type Of Service Code 1 1 - Whole blood only eff 01/96, whole blood or packed red cells before 01/96
      HCPCS Anesthesia Base Unit Quantity 0
      HCPCS Code Added Date 1/1/2019
      HCPCS Action Effective Date 1/1/2019
      HCPCS Action Code N - No maintenance for this code

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      This page was last updated on: 7/1/2024