Question 1

What is HCPCS code M1242?

Accepted Answer

HCPCS code M1242 is "Pt no resp imprt to me". Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life

Question 2

What category is M1242 in?

Accepted Answer

M1242 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1242?

Accepted Answer

Use M1242 when billing for pt no resp imprt to me. 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 M1242 covered by Medicare?

Accepted Answer

Coverage for M1242 (Pt no resp imprt to me) 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 M1242?

Accepted Answer

Documentation for M1242 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).