Question 1

What is HCPCS code M1285?

Accepted Answer

HCPCS code M1285 is "Scrn mam perf rslts not doc". Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified

Question 2

What category is M1285 in?

Accepted Answer

M1285 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1285?

Accepted Answer

Use M1285 when billing for scrn mam perf rslts not doc. 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 M1285 covered by Medicare?

Accepted Answer

Coverage for M1285 (Scrn mam perf rslts not doc) 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 M1285?

Accepted Answer

Documentation for M1285 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).