Question 1

What is HCPCS code M1485?

Accepted Answer

HCPCS code M1485 is "Neg viro resp hep c/qual rna". Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period

Question 2

What category is M1485 in?

Accepted Answer

M1485 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1485?

Accepted Answer

Use M1485 when billing for neg viro resp hep c/qual rna. 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 M1485 covered by Medicare?

Accepted Answer

Coverage for M1485 (Neg viro resp hep c/qual rna) 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 M1485?

Accepted Answer

Documentation for M1485 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).