Question 1

What is HCPCS code M1379?

Accepted Answer

HCPCS code M1379 is "10 yr fu no rec rsn not giv". A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified

Question 2

What category is M1379 in?

Accepted Answer

M1379 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1379?

Accepted Answer

Use M1379 when billing for 10 yr fu no rec rsn not giv. 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 M1379 covered by Medicare?

Accepted Answer

Coverage for M1379 (10 yr fu no rec rsn not giv) 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 M1379?

Accepted Answer

Documentation for M1379 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).