M1375 : HCPCS Code (2025) : JSON

M1375 : An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period ( Ra dx enc 90 days dur per pd )

HCPCS Code : M1375 – JSON Data Format

                    
{
  "HCPCS": {
    "HCPC": "M1375",
    "LongDescription": "An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period",
    "ShortDescription": "Ra dx enc 90 days dur per pd",
    "PricingIndicators": {
      "PricingIndicator": {
        "PricingIndicatorName": "00",
        "PricingIndicatorCode": "Service not separately priced by part B (e.g., services not covered, bundled, used by part a only, etc.)"
      }
    },
    "MPI": "9",
    "MultiplePricingIndicatorCode": "Not applicable as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99')",
    "CIMs": null,
    "MCMs": "",
    "Statute": null,
    "LabCertifications": null,
    "XReferences": null,
    "Coverage": "C",
    "CoverageDescription": "Carrier judgment",
    "ASCPayGrp": null,
    "ASCPayGrpEffDate": null,
    "MOGPayGrp": null,
    "MOGPaymentGroupCode": null,
    "MOGPayInd": null,
    "MOGPaymentPolicyIndicator": null,
    "MOGEffDate": null,
    "ProcNote": null,
    "BETOS": "Z2",
    "BETOSDescription": "Undefined codes",
    "TypeOfServices": {
      "TypeOfService": {
        "TOS": "1",
        "TypeOfServiceCode": "Medical care"
      }
    },
    "AnestBaseUnits": "0",
    "CodeAddDate": "20250101",
    "ActionEffDate": "20250101",
    "TermDate": null,
    "ActionCode": "N",
    "ActionCodeDescription": "No maintenance for this code"
  }
}