M1330 — Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)
M1330 is a HCPCS Level II code for documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up). 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 M1330
- Long descriptor
- Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)
- Short descriptor
- Doc pts rsn no f/u xm
- 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 M1330
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If M1330 is not quite right, the correct code is very often within a few positions of it.
- 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
- M1327Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks
- M1328Patients with a diagnosis of acute vitreous hemorrhage
- M1329Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter
- M1331Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam
- M1332Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks
- M1333Acute vitreous hemorrhage
- M1334Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter
- M1335Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)
- M1336Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks
- M1337Acute pvd
- M1338Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period
Questions about M1330
What is HCPCS code M1330?
M1330 is a HCPCS Level II code for documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up). It sits in the Medical Services section.
Does Medicare cover M1330?
The CMS HCPCS file marks M1330 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 M1330 paid under the physician fee schedule?
M1330 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.