Question 1

What is HCPCS code M1176?

Accepted Answer

HCPCS code M1176 is "No 2 hzv 10/2017-meas pd". Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period

Question 2

What category is M1176 in?

Accepted Answer

M1176 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1176?

Accepted Answer

Use M1176 when billing for no 2 hzv 10/2017-meas 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 M1176 covered by Medicare?

Accepted Answer

Coverage for M1176 (No 2 hzv 10/2017-meas 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 M1176?

Accepted Answer

Documentation for M1176 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).