Question 1

What is HCPCS code M1479?

Accepted Answer

HCPCS code M1479 is "Pt func cap not allow impr". Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders

Question 2

What category is M1479 in?

Accepted Answer

M1479 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1479?

Accepted Answer

Use M1479 when billing for pt func cap not allow impr. 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 M1479 covered by Medicare?

Accepted Answer

Coverage for M1479 (Pt func cap not allow impr) 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 M1479?

Accepted Answer

Documentation for M1479 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).