Question 1

What is HCPCS code M1234?

Accepted Answer

HCPCS code M1234 is "Pt hcv rctv aby f/u neg". Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia

Question 2

What category is M1234 in?

Accepted Answer

M1234 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1234?

Accepted Answer

Use M1234 when billing for pt hcv rctv aby f/u neg. 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 M1234 covered by Medicare?

Accepted Answer

Coverage for M1234 (Pt hcv rctv aby f/u neg) 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 M1234?

Accepted Answer

Documentation for M1234 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).