Question 1

What is HCPCS code M1402?

Accepted Answer

HCPCS code M1402 is "Init chemo w/def dur ec grp". Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group

Question 2

What category is M1402 in?

Accepted Answer

M1402 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1402?

Accepted Answer

Use M1402 when billing for init chemo w/def dur ec grp. 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 M1402 covered by Medicare?

Accepted Answer

Coverage for M1402 (Init chemo w/def dur ec grp) 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 M1402?

Accepted Answer

Documentation for M1402 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).