Question 1

What is HCPCS code M1328?

Accepted Answer

HCPCS code M1328 is "Pts dx acute vitreous hem". Patients with a diagnosis of acute vitreous hemorrhage

Question 2

What category is M1328 in?

Accepted Answer

M1328 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1328?

Accepted Answer

Use M1328 when billing for pts dx acute vitreous hem. 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 M1328 covered by Medicare?

Accepted Answer

Coverage for M1328 (Pts dx acute vitreous hem) 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 M1328?

Accepted Answer

Documentation for M1328 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).