Question 1

What is HCPCS code M1196?

Accepted Answer

HCPCS code M1196 is "Ixv nrs vrs iqa >=4". Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4

Question 2

What category is M1196 in?

Accepted Answer

M1196 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1196?

Accepted Answer

Use M1196 when billing for ixv nrs vrs iqa >=4. 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 M1196 covered by Medicare?

Accepted Answer

Coverage for M1196 (Ixv nrs vrs iqa >=4) 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 M1196?

Accepted Answer

Documentation for M1196 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).