Question 1

What is HCPCS code M1301?

Accepted Answer

HCPCS code M1301 is "Pt recv tbco cess interv". Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)

Question 2

What category is M1301 in?

Accepted Answer

M1301 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1301?

Accepted Answer

Use M1301 when billing for pt recv tbco cess interv. 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 M1301 covered by Medicare?

Accepted Answer

Coverage for M1301 (Pt recv tbco cess interv) 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 M1301?

Accepted Answer

Documentation for M1301 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).