Question 1

What is HCPCS code M1064?

Accepted Answer

HCPCS code M1064 is "Shing vac doc adm or pv rec". Shingrix vaccine documented as administered or previously received

Question 2

What category is M1064 in?

Accepted Answer

M1064 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1064?

Accepted Answer

Use M1064 when billing for shing vac doc adm or pv rec. 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 M1064 covered by Medicare?

Accepted Answer

Coverage for M1064 (Shing vac doc adm or pv rec) 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 M1064?

Accepted Answer

Documentation for M1064 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).