Question 1

What is HCPCS code M1251?

Accepted Answer

HCPCS code M1251 is "Pts proxy cmplt hu surv". Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)

Question 2

What category is M1251 in?

Accepted Answer

M1251 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1251?

Accepted Answer

Use M1251 when billing for pts proxy cmplt hu surv. 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 M1251 covered by Medicare?

Accepted Answer

Coverage for M1251 (Pts proxy cmplt hu surv) 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 M1251?

Accepted Answer

Documentation for M1251 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).