Question 1

What is HCPCS code M1268?

Accepted Answer

HCPCS code M1268 is "Pt ac stat kid trnsplt wtlst". Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period

Question 2

What category is M1268 in?

Accepted Answer

M1268 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1268?

Accepted Answer

Use M1268 when billing for pt ac stat kid trnsplt wtlst. 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 M1268 covered by Medicare?

Accepted Answer

Coverage for M1268 (Pt ac stat kid trnsplt wtlst) 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 M1268?

Accepted Answer

Documentation for M1268 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).