Question 1

What is HCPCS code M1346?

Accepted Answer

HCPCS code M1346 is "No pam inc 6 pts 4-12 mo". Patients who did not have a net increase in pam score of at least 6 points within a 4 to 12 month period

Question 2

What category is M1346 in?

Accepted Answer

M1346 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1346?

Accepted Answer

Use M1346 when billing for no pam inc 6 pts 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 M1346 covered by Medicare?

Accepted Answer

Coverage for M1346 (No pam inc 6 pts 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 M1346?

Accepted Answer

Documentation for M1346 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).