Question 1

What is HCPCS code M1273?

Accepted Answer

HCPCS code M1273 is "Pts snf 1 yr dialysis". Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form

Question 2

What category is M1273 in?

Accepted Answer

M1273 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1273?

Accepted Answer

Use M1273 when billing for pts snf 1 yr dialysis. 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 M1273 covered by Medicare?

Accepted Answer

Coverage for M1273 (Pts snf 1 yr dialysis) 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 M1273?

Accepted Answer

Documentation for M1273 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).