Q: What category is M1046 in?

M1046 belongs to HCPCS Category M (Medical Services).

Q: When should I use HCPCS code M1046?

Use M1046 when billing for fs oks 9-15mo < 37 < 71. 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.

Q: Is M1046 covered by Medicare?

Coverage for M1046 (Fs oks 9-15mo < 37 < 71) 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.

Q: What documentation is required for M1046?

Documentation for M1046 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).

Question 1

What is HCPCS code M1046?

Accepted Answer

HCPCS code M1046 is "Fs oks 9-15mo < 37 < 71". Functional status measured by the oxford knee score (oks) at one year (9 to 15 months) postoperatively was less than 37 or the knee injury and osteoarthritis outcome score joint replacement (koos, jr.) was less than 71 postoperatively

Question 2

What category is M1046 in?

Accepted Answer

M1046 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1046?

Accepted Answer

Use M1046 when billing for fs oks 9-15mo < 37 < 71. 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 M1046 covered by Medicare?

Accepted Answer

Coverage for M1046 (Fs oks 9-15mo < 37 < 71) 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 M1046?

Accepted Answer

Documentation for M1046 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).