M1376 : HCPCS Code (2025) : XML

M1376 : 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 )

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PDF | M1376 in JSON format

JSON formats.

HCPCS Code : M1376 – XML Data Format

                
<?xml version="1.0" encoding="UTF-8"?>
<HCPCS>
	<HCPC>
		M1376
	</HCPC>
	<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
	</LongDescription>
	<ShortDescription>
		Ra dx enc 90 days dur per pd
	</ShortDescription>
	<PricingIndicators>
		<PricingIndicator>
			<PricingIndicatorName>
				00
			</PricingIndicatorName>
			<PricingIndicatorCode>
				Service not separately priced by part B (e.g., services not covered, bundled, used by part a only, etc.)
			</PricingIndicatorCode>
		</PricingIndicator>
	</PricingIndicators>
	<MPI>
		9
	</MPI>
	<MultiplePricingIndicatorCode>
		Not applicable as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is &#39;99&#39;)
	</MultiplePricingIndicatorCode>
	<CIMs/>
	<MCMs>
	</MCMs>
	<Statute/>
	<LabCertifications/>
	<XReferences/>
	<Coverage>
		C
	</Coverage>
	<CoverageDescription>
		Carrier judgment
	</CoverageDescription>
	<ASCPayGrp/>
	<ASCPayGrpEffDate/>
	<MOGPayGrp/>
	<MOGPaymentGroupCode/>
	<MOGPayInd/>
	<MOGPaymentPolicyIndicator/>
	<MOGEffDate/>
	<ProcNote/>
	<BETOS>
		Z2
	</BETOS>
	<BETOSDescription>
		Undefined codes
	</BETOSDescription>
	<TypeOfServices>
		<TypeOfService>
			<TOS>
				1
			</TOS>
			<TypeOfServiceCode>
				Medical care
			</TypeOfServiceCode>
		</TypeOfService>
	</TypeOfServices>
	<AnestBaseUnits>
		0
	</AnestBaseUnits>
	<CodeAddDate>
		20250101
	</CodeAddDate>
	<ActionEffDate>
		20250101
	</ActionEffDate>
	<TermDate/>
	<ActionCode>
		N
	</ActionCode>
	<ActionCodeDescription>
		No maintenance for this code
	</ActionCodeDescription>
</HCPCS>

HCPCS XML XSD Schema

                
<xs:schema attributeFormDefault="unqualified" elementFormDefault="qualified" xmlns:xs="http://www.w3.org/2001/XMLSchema">
  <xs:element name="HCPCS">
    <xs:complexType>
      <xs:sequence>
        <xs:element type="xs:string" name="HCPC"/>
        <xs:element type="xs:string" name="LongDescription"/>
        <xs:element type="xs:string" name="ShortDescription"/>
        <xs:element name="PricingIndicators">
          <xs:complexType>
            <xs:sequence>
              <xs:element name="PricingIndicator" maxOccurs="unbounded" minOccurs="0">
                <xs:complexType>
                  <xs:sequence>
                    <xs:element type="xs:string" name="PricingIndicatorName"/>
                    <xs:element type="xs:string" name="PricingIndicatorCode"/>
                  </xs:sequence>
                </xs:complexType>
              </xs:element>
            </xs:sequence>
          </xs:complexType>
        </xs:element>
        <xs:element type="xs:string" name="MPI"/>
        <xs:element type="xs:string" name="MultiplePricingIndicatorCode"/>
        <xs:element name="CIMs">
          <xs:complexType>
            <xs:sequence>
              <xs:element type="xs:string" name="CIM" maxOccurs="unbounded" minOccurs="0"/>
            </xs:sequence>
          </xs:complexType>
        </xs:element>
        <xs:element name="MCMs">
          <xs:complexType>
            <xs:sequence>
              <xs:element type="xs:string" name="MCM" maxOccurs="unbounded" minOccurs="0"/>
            </xs:sequence>
          </xs:complexType>
        </xs:element>
        <xs:element type="xs:string" name="Statute"/>
        <xs:element name="LabCertifications">
          <xs:complexType>
            <xs:sequence>
              <xs:element name="LabCertification" maxOccurs="unbounded" minOccurs="0">
                <xs:complexType>
                  <xs:sequence>
                    <xs:element type="xs:string" name="LabCert"/>
                    <xs:element type="xs:string" name="LabCertificationCode"/>
                  </xs:sequence>
                </xs:complexType>
              </xs:element>
            </xs:sequence>
          </xs:complexType>
        </xs:element>
        <xs:element name="XReferences">
          <xs:complexType>
            <xs:sequence>
              <xs:element name="XReference" maxOccurs="unbounded" minOccurs="0">
                <xs:complexType>
                  <xs:sequence>
                    <xs:element type="xs:string" name="XRef"/>
                    <xs:element type="xs:string" name="XRefDescription"/>
                  </xs:sequence>
                </xs:complexType>
              </xs:element>
            </xs:sequence>
          </xs:complexType>
        </xs:element>
        <xs:element type="xs:string" name="Coverage"/>
        <xs:element type="xs:string" name="CoverageDescription"/>
        <xs:element type="xs:string" name="ASCPayGrp"/>
        <xs:element type="xs:string" name="ASCPayGrpEffDate"/>
        <xs:element type="xs:string" name="MOGPayGrp"/>
        <xs:element type="xs:string" name="MOGPaymentGroupCode"/>
        <xs:element type="xs:string" name="MOGPayInd"/>
        <xs:element type="xs:string" name="MOGPaymentPolicyIndicator"/>
        <xs:element type="xs:string" name="MOGEffDate"/>
        <xs:element type="xs:string" name="ProcNote"/>
        <xs:element type="xs:string" name="BETOS"/>
        <xs:element type="xs:string" name="BETOSDescription"/>
        <xs:element name="TypeOfServices">
          <xs:complexType>
            <xs:sequence>
              <xs:element name="TypeOfService" maxOccurs="unbounded" minOccurs="0">
                <xs:complexType>
                  <xs:sequence>
                    <xs:element type="xs:string" name="TOS"/>
                    <xs:element type="xs:string" name="TypeOfServiceCode"/>
                  </xs:sequence>
                </xs:complexType>
              </xs:element>
            </xs:sequence>
          </xs:complexType>
        </xs:element>
        <xs:element type="xs:string" name="AnestBaseUnits"/>
        <xs:element type="xs:float" name="CodeAddDate"/>
        <xs:element type="xs:float" name="ActionEffDate"/>
        <xs:element type="xs:string" name="TermDate"/>
        <xs:element type="xs:string" name="ActionCode"/>
        <xs:element type="xs:string" name="ActionCodeDescription"/>
      </xs:sequence>
    </xs:complexType>
  </xs:element>
</xs:schema>