Question 1

What is HCPCS code M1320?

Accepted Answer

HCPCS code M1320 is "Pts scrn + hrsn". Patients who screened positive for at least 1 of the 5 hrsns

Question 2

What category is M1320 in?

Accepted Answer

M1320 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1320?

Accepted Answer

Use M1320 when billing for pts scrn + hrsn. 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 M1320 covered by Medicare?

Accepted Answer

Coverage for M1320 (Pts scrn + hrsn) 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 M1320?

Accepted Answer

Documentation for M1320 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).