Question 1

What is HCPCS code M1318?

Accepted Answer

HCPCS code M1318 is "Pts no csp doc contact". Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp

Question 2

What category is M1318 in?

Accepted Answer

M1318 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1318?

Accepted Answer

Use M1318 when billing for pts no csp doc contact. 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 M1318 covered by Medicare?

Accepted Answer

Coverage for M1318 (Pts no csp doc contact) 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 M1318?

Accepted Answer

Documentation for M1318 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).