Question 1

What is HCPCS code M1457?

Accepted Answer

HCPCS code M1457 is "Dx asth dur crnt/prv perf pd". Patient had a diagnosis of asthma with any contact during the current or prior performance period or had asthma present on an active problem list any time during the performance period

Question 2

What category is M1457 in?

Accepted Answer

M1457 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1457?

Accepted Answer

Use M1457 when billing for dx asth dur crnt/prv perf pd. 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 M1457 covered by Medicare?

Accepted Answer

Coverage for M1457 (Dx asth dur crnt/prv perf pd) 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 M1457?

Accepted Answer

Documentation for M1457 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).