Question 1

What is HCPCS code M1348?

Accepted Answer

HCPCS code M1348 is "Pam incr 6 pt 4-12 mo". Patients who achieved a net increase in pam score of at least 6-points in a 4 to 12 month period (excellent)

Question 2

What category is M1348 in?

Accepted Answer

M1348 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1348?

Accepted Answer

Use M1348 when billing for pam incr 6 pt 4-12 mo. 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 M1348 covered by Medicare?

Accepted Answer

Coverage for M1348 (Pam incr 6 pt 4-12 mo) 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 M1348?

Accepted Answer

Documentation for M1348 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).