M1280 Bilateral mast/history bi /unilateral mass
Also known as: bilateral mastectomy, both breast removal, double mastectomy
Bilateral mastectomy or history of bilateral mastectomy excluding unilateral mastectomy. Documents female patients with both breasts surgically removed due to cancer or prophylaxis.
In Plain Language
both breasts removed; complete breast surgery
Clinical Context
Used in cancer screening measures to identify and exclude women who have had both breasts removed, making them ineligible for mammography screening recommendations.
RVU Information
CPT M1280 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
Frequently Asked Questions
What is CPT code M1280?
CPT M1280 (Bilateral mast/history bi /unilateral mass) is a M Codes code. Bilateral mastectomy or history of bilateral mastectomy excluding unilateral mastectomy. Documents female patients with both breasts surgically removed due to cancer or prophylaxis.
Is M1280 covered by insurance?
M1280 is a temporary HCPCS code. Coverage varies by payer and may change when permanent codes are assigned. Used in cancer screening measures to identify and exclude women who have had both breasts removed, making them ineligible for mammography screening recommendations.
When is CPT M1280 used?
Used in cancer screening measures to identify and exclude women who have had both breasts removed, making them ineligible for mammography screening recommendations.
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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.