Question 1

What is HCPCS code M1269?

Accepted Answer

HCPCS code M1269 is "Rec'd esrd mcp lst day of mo". Receiving esrd mcp dialysis services by the provider on the last day of the reporting month

Question 2

What category is M1269 in?

Accepted Answer

M1269 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1269?

Accepted Answer

Use M1269 when billing for rec'd esrd mcp lst day of mo. 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 M1269 covered by Medicare?

Accepted Answer

Coverage for M1269 (Rec'd esrd mcp lst day of mo) 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 M1269?

Accepted Answer

Documentation for M1269 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).