Question 1

What is HCPCS code M1245?

Accepted Answer

HCPCS code M1245 is "Pt othr thn true person". Patient provided a response other than "completely true" for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem

Question 2

What category is M1245 in?

Accepted Answer

M1245 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1245?

Accepted Answer

Use M1245 when billing for pt othr thn true person. 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 M1245 covered by Medicare?

Accepted Answer

Coverage for M1245 (Pt othr thn true person) 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 M1245?

Accepted Answer

Documentation for M1245 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).