Question 1

What is HCPCS code M1052?

Accepted Answer

HCPCS code M1052 is "Lg pn not meas w/ vas 1yr po". Leg pain was not measured by the visual analog scale (vas) or numeric pain scale at one year (9 to 15 months) postoperatively

Question 2

What category is M1052 in?

Accepted Answer

M1052 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1052?

Accepted Answer

Use M1052 when billing for lg pn not meas w/ vas 1yr po. 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 M1052 covered by Medicare?

Accepted Answer

Coverage for M1052 (Lg pn not meas w/ vas 1yr po) 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 M1052?

Accepted Answer

Documentation for M1052 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).