Question 1

What is HCPCS code M1233?

Accepted Answer

HCPCS code M1233 is "Pt no hcv aby or result". Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given

Question 2

What category is M1233 in?

Accepted Answer

M1233 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1233?

Accepted Answer

Use M1233 when billing for pt no hcv aby or result. 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 M1233 covered by Medicare?

Accepted Answer

Coverage for M1233 (Pt no hcv aby or result) 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 M1233?

Accepted Answer

Documentation for M1233 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).