Question 1

What is HCPCS code M1470?

Accepted Answer

HCPCS code M1470 is "Hep b vac not rec'd med rsn". Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine)

Question 2

What category is M1470 in?

Accepted Answer

M1470 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1470?

Accepted Answer

Use M1470 when billing for hep b vac not rec'd med rsn. 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 M1470 covered by Medicare?

Accepted Answer

Coverage for M1470 (Hep b vac not rec'd med rsn) 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 M1470?

Accepted Answer

Documentation for M1470 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).