Question 1

What is HCPCS code M1039?

Accepted Answer

HCPCS code M1039 is "Pt dx lum sp reg inf". Patients with a diagnosis of lumbar spine region infection at the time of the procedure

Question 2

What category is M1039 in?

Accepted Answer

M1039 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1039?

Accepted Answer

Use M1039 when billing for pt dx lum sp reg inf. 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 M1039 covered by Medicare?

Accepted Answer

Coverage for M1039 (Pt dx lum sp reg inf) 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 M1039?

Accepted Answer

Documentation for M1039 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).