M1038 HCPCS Level II code: Patients with a diagnosis of lumbar spine region fracture at the time of the procedure
M1038 is the HCPCS code for “Patients with a diagnosis of lumbar spine region fracture at the time of the procedure” in CMS’s October 2026 release, in effect from Oct 1, 2026.
Official description
M1038Patients with a diagnosis of lumbar spine region fracture at the time of the procedure
Short description: Pt dx lum sp reg fract
HCPCS · United States
Medicare details
The indicators CMS publishes with M1038 in its October 2026 file. They describe Medicare’s handling, not another payer’s.
- Medicare coverage
- Carrier judgment
- Medicare pricing
- Service not separately priced by Part B (e.g., services not covered, bundled, used by Part A only, etc.)
- Type of service
- Medical care
- BETOS category
- Undefined codes
- Added
- Jan 1, 2019
Where M1038 sits
- 1M codesMedical services and quality measures
- 2Active code M1038Patients with a diagnosis of lumbar spine region fracture at the time of the procedure
Source and release
- Data release
- HCPCS Level II · October 2026
- Effective date
- Oct 1, 2026
- Publisher
- CMS
This page is built from the HCPCS Level II catalog that Vero Codes reads when it suggests codes: Centers for Medicare & Medicaid Services’s October 2026 release, imported from the publisher’s file and checked against it. The description, notes and structured data come from the same record.
Frequently asked questions
What does HCPCS code M1038 mean?
M1038 is the HCPCS code for “Patients with a diagnosis of lumbar spine region fracture at the time of the procedure” in CMS’s HCPCS Level II October 2026 release.
Does Medicare cover M1038?
CMS lists M1038’s Medicare coverage as “Carrier judgment” and its pricing as “Service not separately priced by Part B (e.g., services not covered, bundled, used by Part A only, etc.)”. Coverage and payment still depend on the patient, the setting, the documentation and the payer.
Which HCPCS Level II release does this page use?
It uses CMS’s October 2026 release, in effect from Oct 1, 2026 to Dec 31, 2026. It is a reference: confirm the code against the current list and the payer’s rules before you submit it.
Codes beside M1038
All M codesM1032Adults currently taking pharmacotherapy for oudM1033Pharmacotherapy for oud initiated after june 30th of performance periodM1034Adults who have at least 180 days of continuous pharmacotherapy with a medication prescribed for oud without a gap of more than seven daysM1035Adults who are deliberately phased out of medication assisted treatment (mat) prior to 180 days of continuous treatmentM1036Adults who have not had at least 180 days of continuous pharmacotherapy with a medication prescribed for oud without a gap of more than seven daysM1037Patients with a diagnosis of lumbar spine region cancer at the time of the procedureM1039Patients with a diagnosis of lumbar spine region infection at the time of the procedureM1040Patients with a diagnosis of lumbar idiopathic or congenital scoliosisM1041Patient had cancer, acute fracture or infection related to the lumbar spine or patient had neuromuscular, idiopathic or congenital lumbar scoliosisM1042Functional status measurement with score was obtained utilizing the oswestry disability index (odi version 2.1a) patient reported outcome tool within three months preoperatively…M1043Functional status was not measured by the oswestry disability index (odi version 2.1a) at one year (9 to 15 months) postoperativelyM1044Functional status was measured by the oswestry disability index (odi version 2.1a) patient reported outcome tool within three months preoperatively and at one year (9 to 15…