Question 1

What is HCPCS code M1491?

Accepted Answer

HCPCS code M1491 is "Rec'd esrd mcp dur perf pd". Receiving esrd mcp dialysis services by the provider during the performance period

Question 2

What category is M1491 in?

Accepted Answer

M1491 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1491?

Accepted Answer

Use M1491 when billing for rec'd esrd mcp dur 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 M1491 covered by Medicare?

Accepted Answer

Coverage for M1491 (Rec'd esrd mcp dur 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 M1491?

Accepted Answer

Documentation for M1491 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).