Q: What category is M1224 in?

M1224 belongs to HCPCS Category M (Medical Services).

Q: When should I use HCPCS code M1224?

Use M1224 when billing for iop dec <20% from base. 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.

Q: Is M1224 covered by Medicare?

Coverage for M1224 (Iop dec <20% from base) 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.

Q: What documentation is required for M1224?

Documentation for M1224 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).

Question 1

What is HCPCS code M1224?

Accepted Answer

HCPCS code M1224 is "Iop dec <20% from base". Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level

Question 2

What category is M1224 in?

Accepted Answer

M1224 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1224?

Accepted Answer

Use M1224 when billing for iop dec <20% from base. 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 M1224 covered by Medicare?

Accepted Answer

Coverage for M1224 (Iop dec <20% from base) 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 M1224?

Accepted Answer

Documentation for M1224 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).