Q: What category is M1378 in?

M1378 belongs to HCPCS Category M (Medical Services).

Q: When should I use HCPCS code M1378?

Use M1378 when billing for med rsn no 10 yr fu colscope. 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.

Q: Is M1378 covered by Medicare?

Coverage for M1378 (Med rsn no 10 yr fu colscope) 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.

Q: What documentation is required for M1378?

Documentation for M1378 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).

Question 1

What is HCPCS code M1378?

Accepted Answer

HCPCS code M1378 is "Med rsn no 10 yr fu colscope". Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)

Question 2

What category is M1378 in?

Accepted Answer

M1378 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1378?

Accepted Answer

Use M1378 when billing for med rsn no 10 yr fu colscope. 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 M1378 covered by Medicare?

Accepted Answer

Coverage for M1378 (Med rsn no 10 yr fu colscope) 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 M1378?

Accepted Answer

Documentation for M1378 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).