Question 1

What is HCPCS code M1347?

Accepted Answer

HCPCS code M1347 is "Pt pam incr 3 pt 4-12 mo". Patients who achieved a net increase in pam score of at least 3 points in a 4 to 12 month period (passing)

Question 2

What category is M1347 in?

Accepted Answer

M1347 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1347?

Accepted Answer

Use M1347 when billing for pt pam incr 3 pt 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 M1347 covered by Medicare?

Accepted Answer

Coverage for M1347 (Pt pam incr 3 pt 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 M1347?

Accepted Answer

Documentation for M1347 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).