M1311 Aphlx to vax bef enc
Also known as: vaccine anaphylaxis history, severe vaccine allergy, vaccine contraindicated
Documented anaphylaxis to vaccine prior to encounter. Records severe allergic reaction history preventing vaccination.
In Plain Language
severe allergic reaction to vaccines; can't get vaccines
Clinical Context
Quality measure exception documenting documented severe allergic reaction to vaccines as contraindication to immunization.
RVU Information
CPT M1311 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 M1311?
CPT M1311 (Aphlx to vax bef enc) is a M Codes code. Documented anaphylaxis to vaccine prior to encounter. Records severe allergic reaction history preventing vaccination.
Is M1311 covered by insurance?
M1311 is a temporary HCPCS code. Coverage varies by payer and may change when permanent codes are assigned. Quality measure exception documenting documented severe allergic reaction to vaccines as contraindication to immunization.
When is CPT M1311 used?
Quality measure exception documenting documented severe allergic reaction to vaccines as contraindication to immunization.
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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.