M1405 Pt with recur/prog
Also known as: recurrent breast cancer, progressive cancer, metastatic disease
Performance measure documenting patient with recurrent or progressive breast cancer. Captures advanced or metastatic disease status.
In Plain Language
Cancer came back after treatment; Cancer spreading despite treatment
Clinical Context
Documents patients with recurrent locoregional or metastatic breast cancer. Often represents denominator exclusion from early-stage cancer treatment measures.
RVU Information
CPT M1405 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 M1405?
CPT M1405 (Pt with recur/prog) is a M Codes code. Performance measure documenting patient with recurrent or progressive breast cancer. Captures advanced or metastatic disease status.
Is M1405 covered by insurance?
M1405 is a temporary HCPCS code. Coverage varies by payer and may change when permanent codes are assigned. Documents patients with recurrent locoregional or metastatic breast cancer. Often represents denominator exclusion from early-stage cancer treatment measures.
When is CPT M1405 used?
Documents patients with recurrent locoregional or metastatic breast cancer. Often represents denominator exclusion from early-stage cancer treatment measures.
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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.