HCPCS M1300
Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)
HCPCS
M1300
Medical Services
Description
Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)
Common Specialties
Family Medicine, Emergency Medicine, Pediatrics
Documentation Requirements
- Document clinical indications and clear medical necessity supporting the encounter or procedure.
- Ensure complete provider signatures, credentials, date, and specific place of service (POS).
- Verify documentation strictly supports code specificity to prevent downcoding or claim denials.
Billing & Coding Tips
- Verify current payer fee schedules, NCCI edits, and Medically Unlikely Edits (MUEs).
- Append correct modifiers (e.g., 25, 59, 26, TC) where distinct procedural services or components apply.
- Confirm pre-authorization rules with Medicare, Medicaid, and commercial plans before submission.
Related Codes
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