Question 1

What is HCPCS code M1182?

Accepted Answer

HCPCS code M1182 is "Not elg pre ex ibd/uc/crohn". Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohn's disease)

Question 2

What category is M1182 in?

Accepted Answer

M1182 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1182?

Accepted Answer

Use M1182 when billing for not elg pre ex ibd/uc/crohn. 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 M1182 covered by Medicare?

Accepted Answer

Coverage for M1182 (Not elg pre ex ibd/uc/crohn) 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 M1182?

Accepted Answer

Documentation for M1182 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).