Question 1

What is HCPCS code M1200?

Accepted Answer

HCPCS code M1200 is "Ace-i/arb rx". Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period

Question 2

What category is M1200 in?

Accepted Answer

M1200 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1200?

Accepted Answer

Use M1200 when billing for ace-i/arb rx. 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 M1200 covered by Medicare?

Accepted Answer

Coverage for M1200 (Ace-i/arb rx) 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 M1200?

Accepted Answer

Documentation for M1200 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).