M1485 : HCPCS Code (2026) : JSON

M1485 : Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period ( Neg viro resp hep c/qual rna )

HCPCS Code : M1485 – JSON Data Format

                    
{
  "HCPCS": {
    "HCPC": "M1485",
    "LongDescription": "Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period",
    "ShortDescription": "Neg viro resp hep c/qual rna",
    "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"
  }
}