M1215 — Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)
M1215 is a HCPCS Level II code for documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy). It belongs to the Medical Services section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusM
Measurement code. Used for reporting purposes only; never paid.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
The CMS record for M1215
- Long descriptor
- Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)
- Short descriptor
- Med rsn for no doc spiro
- Added
- January 1, 2024
- BETOS
- Z2
- Pricing indicator
- 00 — Not priced by Part B
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.
Codes adjacent to M1215
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If M1215 is not quite right, the correct code is very often within a few positions of it.
- M1207Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety
- M1208Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety
- M1209At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses
- M1210At least two orders for high-risk medications from the same drug class, (table 4), not ordered
- M1211Most recent glycemic status assessment (hba1c or gmi) level > 9.0%
- M1212Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period
- M1213No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%
- M1214Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed
- M1216No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter
- M1217Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)
- M1218Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)
- M1219Anaphylaxis due to the vaccine on or before the date of the encounterterminated
- M1220Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy
- M1221Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy
- M1222Glaucoma plan of care not documented, reason not otherwise specified
- M1223Glaucoma plan of care documented
Questions about M1215
What is HCPCS code M1215?
M1215 is a HCPCS Level II code for documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy). It sits in the Medical Services section.
Does Medicare cover M1215?
The CMS HCPCS file marks M1215 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
How is M1215 paid under the physician fee schedule?
M1215 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.