M1386 — Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period
M1386 is a HCPCS Level II code for patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period. 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
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The CMS record for M1386
- Long descriptor
- Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period
- Short descriptor
- Exc sx melmn or mlnm is
- Added
- January 1, 2025
- 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 M1386
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If M1386 is not quite right, the correct code is very often within a few positions of it.
- M1378Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)
- M1379A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified
- M1380Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under "denominator note" or the long-acting injectable antipsychotic medications listed under "denominator note"
- M1381Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure
- M1382Patient encounter during the performance period with place of service code 11
- M1383Acute pvd
- M1384Patients who died during the performance period
- M1385Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up
- M1387Patients who died during the performance period
- M1388Patients with documentation of an exam performed for recurrence of melanoma
- M1390Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period
- M1391All patients who were diagnosed with recurrent melanoma during the current performance period
- M1392Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by phone, mail or secure electronic mail - at least one method must be documented)
- M1393Patients who were not diagnosed with recurrent melanoma during the current performance period
- M1394Stages i-iii breast cancer
- M1395Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group
Questions about M1386
What is HCPCS code M1386?
M1386 is a HCPCS Level II code for patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period. It sits in the Medical Services section.
Does Medicare cover M1386?
The CMS HCPCS file marks M1386 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 M1386 paid under the physician fee schedule?
M1386 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.