M1257

M1257 — Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified

HCPCSActiveBETOS Z2

M1257 is a HCPCS Level II code for cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified. 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 M1257

Long descriptor: Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified
Short descriptor: Cvd risk assess not perf
Added: January 1, 2024
BETOS: Z2
Pricing indicator: 00 — Not priced by Part B

Codes adjacent to M1257

HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If M1257 is not quite right, the correct code is very often within a few positions of it.

M1249Patient responded "completely true" for the question of patient felt this provider and team understood what is important to me in my life
M1250Patient responded as "completely true" for the question of patient felt heard and understood by this provider and team
M1251Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)
M1252Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit
M1253Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)
M1254Patients who were deceased when the hu survey reached them
M1255Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)
M1256Prior history of known cvd
M1258Cvd risk assessment performed, have a documented calculated risk score
M1259Patient status documented within the first year of initiating dialysis
M1260Patient status not documented within the first year of initiating dialysis
M1261Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis
M1262Patients who had a transplant prior to initiation of dialysis
M1263Patients in hospice on their initiation of dialysis date or during the month of evaluation
M1264Patients age 75 or older on their initiation of dialysis dateterminated
M1265Cms medical evidence form 2728 for dialysis patients: initial form completed

Questions about M1257

What is HCPCS code M1257?

M1257 is a HCPCS Level II code for cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified. It sits in the Medical Services section.

Does Medicare cover M1257?

The CMS HCPCS file marks M1257 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 M1257 paid under the physician fee schedule?

M1257 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.