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2025 HCPCS code M1335

Documentation of patient reason(s) for not having a follow-up exam (e.g., inadequate time for follow up).

This is a supplemental tracking code that may be appropriate for data collection and performance measurement. This code is not a substitute for a code describing the procedure or service rendered.

The medical record should indicate one or more patient reasons why the patient did not have a follow-up examination. An example is lack of adequate time for follow-up.

In simple words: This code is used when a patient doesn't have a follow-up appointment for reasons like not having enough time.

Documentation shows one or more patient reasons for not having a follow-up exam, such as inadequate time.

Example 1: A patient is scheduled for a follow-up exam after a surgical procedure, but they cancel it due to work commitments and difficulty rescheduling., A patient misses a follow-up appointment for diabetes management because they lack transportation to the clinic., A patient declines a follow-up consultation for their mental health due to personal reasons and expresses no desire for future follow-up at this time.

The documentation must clearly state the patient's reason(s) for not having the follow-up exam.

** HCPCS Level II M codes may be reported by providers participating in programs designed to improve the quality of patient care through certain incentives to participating providers. See program guidelines for complete submission requirements and procedures.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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