Question 1

What is HCPCS code M1345?

Accepted Answer

HCPCS code M1345 is "Pt bsln pam, 2nd scr 4-12 mo". Patients who had a baseline pam score and a second score within 4 to 12 month of baseline pam score

Question 2

What category is M1345 in?

Accepted Answer

M1345 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1345?

Accepted Answer

Use M1345 when billing for pt bsln pam, 2nd scr 4-12 mo. 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 M1345 covered by Medicare?

Accepted Answer

Coverage for M1345 (Pt bsln pam, 2nd scr 4-12 mo) 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 M1345?

Accepted Answer

Documentation for M1345 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).