HCPCS M1179
Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period
HCPCS
M1179
Medical Services
Description
Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period
Common Specialties
Family Medicine
Documentation Requirements
- Document clinical indications and clear medical necessity supporting the encounter or procedure.
- Ensure complete provider signatures, credentials, date, and specific place of service (POS).
- Verify documentation strictly supports code specificity to prevent downcoding or claim denials.
Billing & Coding Tips
- Verify current payer fee schedules, NCCI edits, and Medically Unlikely Edits (MUEs).
- Append correct modifiers (e.g., 25, 59, 26, TC) where distinct procedural services or components apply.
- Confirm pre-authorization rules with Medicare, Medicaid, and commercial plans before submission.
Related Codes
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