M1151 — Patients with a history of heart transplant or with a left ventricular assist device (lvad)
M1151 is a HCPCS Level II code for patients with a history of heart transplant or with a left ventricular assist device (lvad). 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 M1151
- Long descriptor
- Patients with a history of heart transplant or with a left ventricular assist device (lvad)
- Short descriptor
- Pt w/ hx trnsplt or lvad
- Added
- January 1, 2023
- 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 M1151
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If M1151 is not quite right, the correct code is very often within a few positions of it.
- M1143Initiated episode of rehabilitation therapy, medical, or chiropractic care for neck impairment
- M1144Ongoing care not indicated, patient seen only 1-2 visits (e.g., home program only, referred to another provider or facility, consultation onlyterminated
- M1145Most favored nation (mfn) model drug add-on amount, per dose, (do not bill with line items that have the jw modifier)terminated
- M1146Ongoing care not clinically indicated because the patient needed a home program only, referral to another provider or facility, or consultation only, as documented in the medical record
- M1147Ongoing care not medically possible because the patient was discharged early due to specific medical events, documented in the medical record, such as the patient became hospitalized or scheduled for surgery
- M1148Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)
- M1149Patient unable to complete the neck fs prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility, and an adequate proxy is not available
- M1150Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function
- M1152Patients with a history of heart transplant or with a left ventricular assist device (lvad)
- M1153Patient with diagnosis of osteoporosis on date of encounter
- M1154Hospice services provided to patient any time during the measurement periodterminated
- M1155Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement periodterminated
- M1156Patient received active chemotherapy any time during the measurement periodterminated
- M1157Patient received bone marrow transplant any time during the measurement periodterminated
- M1158Patient had history of immunocompromising conditions prior to or during the measurement periodterminated
- M1159Hospice services provided to patient any time during the measurement period
Questions about M1151
What is HCPCS code M1151?
M1151 is a HCPCS Level II code for patients with a history of heart transplant or with a left ventricular assist device (lvad). It sits in the Medical Services section.
Does Medicare cover M1151?
The CMS HCPCS file marks M1151 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 M1151 paid under the physician fee schedule?
M1151 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.