Question 1

What is HCPCS code M1195?

Accepted Answer

HCPCS code M1195 is "Rpt wo imp/con mmr/msi". Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given

Question 2

What category is M1195 in?

Accepted Answer

M1195 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1195?

Accepted Answer

Use M1195 when billing for rpt wo imp/con mmr/msi. 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 M1195 covered by Medicare?

Accepted Answer

Coverage for M1195 (Rpt wo imp/con mmr/msi) 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 M1195?

Accepted Answer

Documentation for M1195 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).