M1331 Pts evaluation ini xm 8 wks
Also known as: eye exam done within 8 weeks, retinal evaluation completed, dilated exam on time
Patients with initial eye examination within 8 weeks. Documents completion of required retinal evaluation within specified timeframe.
In Plain Language
eye doctor visit completed; retinal check done in time
Clinical Context
Ophthalmology quality measure documenting appropriate completion of initial or follow-up retinal examination within 8-week window for patients with retinal disease.
RVU Information
CPT M1331 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 M1331?
CPT M1331 (Pts evaluation ini xm 8 wks) is a M Codes code. Patients with initial eye examination within 8 weeks. Documents completion of required retinal evaluation within specified timeframe.
Is M1331 covered by insurance?
M1331 is a temporary HCPCS code. Coverage varies by payer and may change when permanent codes are assigned. Ophthalmology quality measure documenting appropriate completion of initial or follow-up retinal examination within 8-week window for patients with retinal disease.
When is CPT M1331 used?
Ophthalmology quality measure documenting appropriate completion of initial or follow-up retinal examination within 8-week window for patients with retinal disease.
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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.