Question 1

What is HCPCS code M1484?

Accepted Answer

HCPCS code M1484 is "No rpt hcv rna perf med rsn". Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)

Question 2

What category is M1484 in?

Accepted Answer

M1484 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1484?

Accepted Answer

Use M1484 when billing for no rpt hcv rna perf 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 M1484 covered by Medicare?

Accepted Answer

Coverage for M1484 (No rpt hcv rna perf 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 M1484?

Accepted Answer

Documentation for M1484 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).