Question 1

What is HCPCS code M1466?

Accepted Answer

HCPCS code M1466 is "Pt disc/lam proc same day". Patient had a lumbar fusion on the same date as the discectomy/laminectomy procedure

Question 2

What category is M1466 in?

Accepted Answer

M1466 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1466?

Accepted Answer

Use M1466 when billing for pt disc/lam proc same day. 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 M1466 covered by Medicare?

Accepted Answer

Coverage for M1466 (Pt disc/lam proc same day) 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 M1466?

Accepted Answer

Documentation for M1466 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).