Question 1

What is HCPCS code M1179?

Accepted Answer

HCPCS code M1179 is "No pcv recd". Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period

Question 2

What category is M1179 in?

Accepted Answer

M1179 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1179?

Accepted Answer

Use M1179 when billing for no pcv recd. 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 M1179 covered by Medicare?

Accepted Answer

Coverage for M1179 (No pcv recd) 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 M1179?

Accepted Answer

Documentation for M1179 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).