Question 1

What is HCPCS code M1058?

Accepted Answer

HCPCS code M1058 is "Pt prm nurs hm res in pp". Patient was a permanent nursing home resident at any time during the performance period

Question 2

What category is M1058 in?

Accepted Answer

M1058 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1058?

Accepted Answer

Use M1058 when billing for pt prm nurs hm res in pp. 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 M1058 covered by Medicare?

Accepted Answer

Coverage for M1058 (Pt prm nurs hm res in pp) 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 M1058?

Accepted Answer

Documentation for M1058 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).