M1318

M1318 — Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp

Q: What is HCPCS code M1318?

M1318 is a HCPCS Level II code for patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp. It sits in the Medical Services section.

Q: Does Medicare cover M1318?

The CMS HCPCS file marks M1318 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.

Q: How is M1318 paid under the physician fee schedule?

M1318 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.

HCPCSActiveBETOS Z2

M1318 is a HCPCS Level II code for patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp. 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 M1318

Long descriptor: Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp
Short descriptor: Pts no csp doc contact
Added: January 1, 2024
BETOS: Z2
Pricing indicator: 00 — Not priced by Part B

Codes adjacent to M1318

HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If M1318 is not quite right, the correct code is very often within a few positions of it.

M1310Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user
M1311Anaphylaxis due to the vaccine on or before the date of the encounter
M1312Patient not screened for tobacco use
M1313Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period
M1314Bmi not documented and no reason is given
M1315Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified
M1316Current tobacco non-user
M1317Patients who are counseled on connection with a csp and explicitly opt out
M1319Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening
M1320Patients who screened positive for at least 1 of the 5 hrsns
M1321Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg
M1322Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye
M1323Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented
M1324Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)
M1325Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within seven (7) weeks of treatment)
M1326Patients with a diagnosis of hypotony

Questions about M1318

What is HCPCS code M1318?

M1318 is a HCPCS Level II code for patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp. It sits in the Medical Services section.

Does Medicare cover M1318?

The CMS HCPCS file marks M1318 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 M1318 paid under the physician fee schedule?

M1318 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.