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M1180 Pt imm ckpt inhib therapy

M Codes

Also known as: immune checkpoint inhibitor ineligibility, ICI contraindication

Patient is immune checkpoint inhibitor therapy ineligible based on clinical criteria including Grade 2 or greater immune-related adverse events.

In Plain Language

Not eligible for immunotherapy; Cancer drug contraindication

Clinical Context

Used in quality measures for immunotherapy-eligible cancers to identify patients with contraindications to immune checkpoint inhibitor therapy such as Grade 2 or higher diarrhea, colitis, or other immune-related adverse events.

RVU Information

CPT M1180 does not have a physician work RVU assigned by CMS. Reimbursement for this code is determined by payer-specific fee schedules.

Billing & Documentation

M-codes cover quality measures and performance reporting. They are used in value-based care programs to track whether specific clinical actions were taken. Documentation must support that the measured action was performed or a valid exclusion applies.

Specialties

OncologyMedical OncologyImmunotherapy

Frequently Asked Questions

What is CPT code M1180?

CPT M1180 (Pt imm ckpt inhib therapy) is a M Codes code. Patient is immune checkpoint inhibitor therapy ineligible based on clinical criteria including Grade 2 or greater immune-related adverse events.

Is M1180 covered by insurance?

M1180 is a temporary HCPCS code. Coverage varies by payer and may change when permanent codes are assigned. Used in quality measures for immunotherapy-eligible cancers to identify patients with contraindications to immune checkpoint inhibitor therapy such as Grade 2 or higher diarrhea, colitis, or other immune-related adverse events.

When is CPT M1180 used?

Used in quality measures for immunotherapy-eligible cancers to identify patients with contraindications to immune checkpoint inhibitor therapy such as Grade 2 or higher diarrhea, colitis, or other immune-related adverse events.

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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.