M1327 Pts no evaluation ini xm no 8 wks
Also known as: no eye exam 8 weeks, dilated exam overdue, retinal exam missed
Patients with no eye evaluation or initial examination within 8 weeks. Documents gaps in required retinal condition monitoring.
In Plain Language
eye doctor visit missed; no eye checkup in 8 weeks
Clinical Context
Ophthalmology quality measure identifying patients with proliferative/serious retinal conditions who are overdue for required comprehensive eye evaluation.
RVU Information
CPT M1327 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 M1327?
CPT M1327 (Pts no evaluation ini xm no 8 wks) is a M Codes code. Patients with no eye evaluation or initial examination within 8 weeks. Documents gaps in required retinal condition monitoring.
Is M1327 covered by insurance?
M1327 is a temporary HCPCS code. Coverage varies by payer and may change when permanent codes are assigned. Ophthalmology quality measure identifying patients with proliferative/serious retinal conditions who are overdue for required comprehensive eye evaluation.
When is CPT M1327 used?
Ophthalmology quality measure identifying patients with proliferative/serious retinal conditions who are overdue for required comprehensive eye evaluation.
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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.