M1327 HCPCS Level II code: Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks
M1327 is the HCPCS code for “Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks” in CMS’s October 2026 release, in effect from Oct 1, 2026.
Official description
M1327Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks
Short description: Pts no eval ini xm no 8 wks
HCPCS · United States
Medicare details
The indicators CMS publishes with M1327 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, 2024
Where M1327 sits
- 1M codesMedical services and quality measures
- 2Active code M1327Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks
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 M1327 mean?
M1327 is the HCPCS code for “Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks” in CMS’s HCPCS Level II October 2026 release.
Does Medicare cover M1327?
CMS lists M1327’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 M1327
All M codesM1321Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hgM1322Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eyeM1323Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of…M1324Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant…M1325Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or…M1326Patients with a diagnosis of hypotonyM1328Patients with a diagnosis of acute vitreous hemorrhageM1329Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounterM1330Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)M1331Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial examM1332Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeksM1333Acute vitreous hemorrhage