M1325 Doc medial rsn not seen
Also known as: documented medical reason, medical excuse for visit miss, justified absence
Documented medical reason not seen at visit. Records valid clinical explanation for missing scheduled appointment or assessment.
In Plain Language
good reason not seen; medical reason for missing visit
Clinical Context
Quality measure exception documenting medical reasons (hospitalization, emergency care, acute illness) explaining missed follow-up visits.
RVU Information
CPT M1325 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 M1325?
CPT M1325 (Doc medial rsn not seen) is a M Codes code. Documented medical reason not seen at visit. Records valid clinical explanation for missing scheduled appointment or assessment.
Is M1325 covered by insurance?
M1325 is a temporary HCPCS code. Coverage varies by payer and may change when permanent codes are assigned. Quality measure exception documenting medical reasons (hospitalization, emergency care, acute illness) explaining missed follow-up visits.
When is CPT M1325 used?
Quality measure exception documenting medical reasons (hospitalization, emergency care, acute illness) explaining missed follow-up visits.
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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.