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M1194 Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both ... more tests were not included (e.g., patient will not be treated with checkpoint inhibitor therapy, no residual carcinoma is present in the sample [tissue exhausted or status post neoadjuvant treatment], insufficient tumor for testing)
HCPCS Procedure & Supply Codes
Code Added 2023-01-01
M1194 - Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therapy, no residual carcinoma is present in the sample [tissue exhausted or status post neoadjuvant treatment], insufficient tumor for testing)
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HCPCS Index Entries (Reverse Index Lookup) 
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DMEPOS Products (Durable Medical Equipment, Prosthetics, Orthotics, Supplies)
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| Modifier | Medicare Allowed | 150% | 200% | My Fee |
|---|---|---|---|---|
| (none) | $0.00 | $0.00 | $0.00 | (your fee) |
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Medicare Participating - Assignment Accepted (Mandatory)
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|---|---|---|---|
| (none) | $0.00 | $##.## | $##.## |
Medicare Non-Participating - Assignment Accepted (Check To Doctor)
| Modifier | Allowed | Medicare 80% | Patient Pays | Limiting Charge (Amount Billed) |
|---|---|---|---|---|
| (none) | $##.## | $##.## | $##.## | $##.## |
Medicare Non-Participating - Assignment NOT Accepted (Check To Patient)
| Modifier | Allowed | Medicare 80% | Patient Pays | Limiting Charge (Amount Billed) |
|---|---|---|---|---|
| (none) | $##.## | $##.## | $##.## | $##.## |
Medicare vs. My Fee Evaluation
| Modifier | Medicare Allowed | 150% | 200% | My Fee |
|---|---|---|---|---|
| (none) | $0.00 | $0.00 | $0.00 | (your fee) |
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Medicare Participating - Assignment Accepted (Mandatory)
| Modifier | Allowed | Medicare 80% | Patient Pays |
|---|---|---|---|
| (none) | $0.00 | $##.## | $##.## |
Medicare Non-Participating - Assignment Accepted (Check To Doctor)
| Modifier | Allowed | Medicare 80% | Patient Pays | Limiting Charge (Amount Billed) |
|---|---|---|---|---|
| (none) | $##.## | $##.## | $##.## | $##.## |
Medicare Non-Participating - Assignment NOT Accepted (Check To Patient)
| Modifier | Allowed | Medicare 80% | Patient Pays | Limiting Charge (Amount Billed) |
|---|---|---|---|---|
| (none) | $##.## | $##.## | $##.## | $##.## |
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RVU Components (by modifier)
| Modifier | Work | Practice Expense | Malpractice Expense | Total |
|---|---|---|---|---|
| (none) | 0 | 0 | 0 | 0.000 |
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Practitioner Labor
| Pre-Service | Intra-Service | Post-Service | Total Time* |
|---|---|---|---|
| ## | ## | ## | ## min |
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Work RVU Components (by modifier)
| Modifier | National Unadjusted Work RVU | Work GPCI | Adjusted Work RVU |
|---|---|---|---|
| (none) | ##.## | ##.## | 0 |
Clinical Labor - Direct Expense
| Staff | Staff Rate | Pre Time | Intra Time | Post Time | Total Time |
|---|---|---|---|---|---|
| $0.00 / min | ## min | ## min | ## min | ## min |
Equipment - Direct Expense
| Item | Purchase Price | Expected Life | Total Time |
|---|---|---|---|
| $##.## | ## years | ## min |
Supplies - Direct Expense
| Item | Unit Price | Quantity | Unit | Amount |
|---|
Indirect Expenses (clerical,overhead, and other) are also included in the practice expense.
PE RVU Components (by modifier)
| Modifier | National Unadjusted PE RVU | PE GPCI | Adjusted PE RVU |
|---|---|---|---|
| (none) | ##.## | ##.## | 0.000 |
RVU Components (by modifier)
| Modifier | Work | Practice Expense | Malpractice Expense | Total |
|---|---|---|---|---|
| (none) | 0 | 0 | 0 | 0.000 |
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Practitioner Labor
| Pre-Service | Intra-Service | Post-Service | Total Time* |
|---|---|---|---|
| ## | ## | ## | ## min |
* Total Time may be greater than the displayed components.
Work RVU Components (by modifier)
| Modifier | National Unadjusted Work RVU | Work GPCI | Adjusted Work RVU |
|---|---|---|---|
| (none) | ##.## | ##.## | 0 |
Clinical Labor (Non-Facility)- Direct Expense
| Staff | Staff Rate | Pre Time | Intra Time | Post Time | Total Time |
|---|---|---|---|---|---|
| $0.00 / min | ## min | ## min | ## min | ## min |
Equipment (Non-Facility)- Direct Expense
| Item | Purchase Price | Expected Life | Total Time |
|---|---|---|---|
| $##.## | ## years | ## min |
Supplies (Non-Facility)- Direct Expense
| Item | Unit Price | Quantity | Unit | Amount |
|---|
Indirect Expenses (clerical,overhead, and other) are also included in the practice expense.
PE RVU Components (by modifier)
| Modifier | National Unadjusted PE RVU | PE GPCI | Adjusted PE RVU |
|---|---|---|---|
| (none) | ##.## | ##.## | 0.000 |
Cross-A-Code™ (ICD-9/10, CPT, Modifiers, NCCI, NDC, ASA CROSSWALK®)
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Medicare Policies & Guidelines (NCDs, LCDs, Articles)
coverage/coverage_content.php?set=HCPCS&c=M1194
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