M1230 HCPCS - PATIENT HAS A REACTIVE HCV ANTIBODY TEST AND DOES NOT HAVE A FOLLOW UP HCV VIRAL TEST, OR PATIENT HAS A REACTIVE HCV ANTIBODY TEST AND HAS A FOLLOW UP HCV VIRAL TEST THAT DETECTS HCV VIREMIA AND IS NOT REFERRED TO A CLINICIAN WHO TREATS HCV INFECTION WITHIN 1 MONTH AND DOES NOT HAVE HCV TREATMENT INITIATED WITHIN 3 MONTHS OF THE REACTIVE HCV ANTIBODY TEST, REASON NOT GIVEN

Code Information

HCPCS Code: M1230
Sequence Number: 0010
Short Description: Pt hcv rctv aby no f/u tst
Long Description: Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment initiated within 3 months of the reactive hcv antibody test, reason not given
Date Added: 1/1/2024
Action Code: N - No maintenance for this code
Action Effective Date: 1/1/2024
Classification: Medical Services
Coding System: HCPCS

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

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

Field Name	Field Value
Healthcare Common Procedure Coding System Code	M1230
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	Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment initiated within 3 months of the reactive hcv antibody test, reason not given
HCPCS Short Description	Pt hcv rctv aby no f/u tst
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	1/1/2024
HCPCS Action Effective Date	1/1/2024
HCPCS Action Code	N - No maintenance for this code