Question 1

What is HCPCS code M1319?

Accepted Answer

HCPCS code M1319 is "Pts csp doc contact". Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening

Question 2

What category is M1319 in?

Accepted Answer

M1319 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1319?

Accepted Answer

Use M1319 when billing for pts 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 M1319 covered by Medicare?

Accepted Answer

Coverage for M1319 (Pts 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 M1319?

Accepted Answer

Documentation for M1319 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).