M1221 Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy

Short descriptor: Dre w/o rtnopthy

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M1221 is the HCPCS Level II code for Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy (2026). It belongs to Section M — Medical Services. Under Medicare, its coverage status is: Carrier judgment. Part B pricing methodology: Not separately priced by Part B.

Classification & CMS Attributes

Medicare Coverage
Carrier judgment (code C)
Part B Pricing
Not separately priced by Part B (indicator 00)
Type of Service
Medical care
Effective Date
2024-01-01
2026 Maintenance
No change this year

References

Cite This Page

Reference M1221 with the canonical source and edition:

M1221 — Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy. ICD-10 Coding Pro (HCPCS Level II 2026). https://icd10codingpro.com/hcpcs-codes/M1221

Canonical URL: https://icd10codingpro.com/hcpcs-codes/M1221

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Reviewed by Prajwal Shrestha, CPC, CRC
Certified Professional Coder (CPC) and Certified Risk Adjustment Coder (CRC) · AAPC Member ID 01997614 · About · Editorial policy · Content last reviewed: 2026-01-01

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