Question 1

What is HCPCS code M1002?

Accepted Answer

HCPCS code M1002 is "Pln to adrs pain not doc". Plan of care for moderate to severe pain not documented on or before the date of the second visit with a clinician, reason not given

Question 2

What category is M1002 in?

Accepted Answer

M1002 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1002?

Accepted Answer

Use M1002 when billing for pln to adrs pain not doc. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is M1002 covered by Medicare?

Accepted Answer

Coverage for M1002 (Pln to adrs pain not doc) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for M1002?

Accepted Answer

Documentation for M1002 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).