Question 1

What is HCPCS code M1288?

Accepted Answer

HCPCS code M1288 is "Doc rsn no hbp scrn or f/u". Documented reason for not screening or recommending a follow-up for high blood pressure

Question 2

What category is M1288 in?

Accepted Answer

M1288 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1288?

Accepted Answer

Use M1288 when billing for doc rsn no hbp scrn or f/u. 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 M1288 covered by Medicare?

Accepted Answer

Coverage for M1288 (Doc rsn no hbp scrn or f/u) 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 M1288?

Accepted Answer

Documentation for M1288 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).