Question 1

What is HCPCS code M1381?

Accepted Answer

HCPCS code M1381 is "Pt sec strk wthin 5 days". Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure

Question 2

What category is M1381 in?

Accepted Answer

M1381 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1381?

Accepted Answer

Use M1381 when billing for pt sec strk wthin 5 days. 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 M1381 covered by Medicare?

Accepted Answer

Coverage for M1381 (Pt sec strk wthin 5 days) 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 M1381?

Accepted Answer

Documentation for M1381 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).