M1473 : HCPCS Code (2026) : JSON

M1473 : Patient situations, at any point during the denominator identification period, where the patient's functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders ( Pt func cap not allow impr )

HCPCS Code : M1473 – JSON Data Format

                    
{
  "HCPCS": {
    "HCPC": "M1473",
    "LongDescription": "Patient situations, at any point during the denominator identification period, where the patient's functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders",
    "ShortDescription": "Pt func cap not allow impr",
    "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": "20260101",
    "ActionEffDate": "20260101",
    "TermDate": null,
    "ActionCode": "N",
    "ActionCodeDescription": "No maintenance for this code"
  }
}