Question 1

What is HCPCS code M1336?

Accepted Answer

HCPCS code M1336 is "Pts eval ini xm 2 wks". Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks

Question 2

What category is M1336 in?

Accepted Answer

M1336 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1336?

Accepted Answer

Use M1336 when billing for pts eval ini xm 2 wks. 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 M1336 covered by Medicare?

Accepted Answer

Coverage for M1336 (Pts eval ini xm 2 wks) 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 M1336?

Accepted Answer

Documentation for M1336 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).