Question 1

What is HCPCS code M1335?

Accepted Answer

HCPCS code M1335 is "Doc pts rsn no f/u xm". Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)

Question 2

What category is M1335 in?

Accepted Answer

M1335 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1335?

Accepted Answer

Use M1335 when billing for doc pts rsn no f/u xm. 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 M1335 covered by Medicare?

Accepted Answer

Coverage for M1335 (Doc pts rsn no f/u xm) 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 M1335?

Accepted Answer

Documentation for M1335 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).