M1338 Pt follow-up 30-180 dys no + imprv
Also known as: no improvement at follow-up, inadequate treatment response, worsened or unchanged
Patient with follow-up visit at 30-180 days without functional improvement. Documents inadequate response to treatment or disease progression.
In Plain Language
feeling no better after treatment; condition not improved
Clinical Context
Quality measure documenting inadequate response to psychiatric or behavioral intervention at follow-up assessment, indicating need for treatment modification.
RVU Information
CPT M1338 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 M1338?
CPT M1338 (Pt follow-up 30-180 dys no + imprv) is a M Codes code. Patient with follow-up visit at 30-180 days without functional improvement. Documents inadequate response to treatment or disease progression.
Is M1338 covered by insurance?
M1338 is a temporary HCPCS code. Coverage varies by payer and may change when permanent codes are assigned. Quality measure documenting inadequate response to psychiatric or behavioral intervention at follow-up assessment, indicating need for treatment modification.
When is CPT M1338 used?
Quality measure documenting inadequate response to psychiatric or behavioral intervention at follow-up assessment, indicating need for treatment modification.
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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.