M1428 Bilateral absence of eyes
Also known as: bilateral anophthalmia, both eyes absent, bilateral absence eyes
Performance measure documenting bilateral absence of eyes (anophthalmia). Captures congenital or acquired absence of both globes.
In Plain Language
Missing both eyes; Both eyes absent congenital or acquired
Clinical Context
Documents bilateral anophthalmia, a congenital or acquired condition where both eyes are absent or non-functional. Excludes patients from vision-related quality measures.
RVU Information
CPT M1428 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 M1428?
CPT M1428 (Bilateral absence of eyes) is a M Codes code. Performance measure documenting bilateral absence of eyes (anophthalmia). Captures congenital or acquired absence of both globes.
Is M1428 covered by insurance?
M1428 is a temporary HCPCS code. Coverage varies by payer and may change when permanent codes are assigned. Documents bilateral anophthalmia, a congenital or acquired condition where both eyes are absent or non-functional. Excludes patients from vision-related quality measures.
When is CPT M1428 used?
Documents bilateral anophthalmia, a congenital or acquired condition where both eyes are absent or non-functional. Excludes patients from vision-related quality measures.
Track This Code in RVU Edge
Log procedures, calculate wRVUs, and benchmark against national data — all in one app.
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.