HCPCS Level II · Medical services and quality measures
M1162Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patient's 13th birthday
✓ Active
Source: CMS HCPCS quarterly update, October 2026. Page updated September 29, 2026.
About M1162
M1162 is an HCPCS Level II code in the M series (medical services and quality measures), describing patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patient's 13th birthday.
It was added to HCPCS effective 01/01/2023.
Its Medicare coverage code is "C", meaning coverage is left to the Medicare contractor's judgment.
Details
- Short description
- Pt enceph due to dtp bef 13
- Date added
- 01/01/2023
- Action effective
- 01/01/2023
- BETOS
- Z2
Related M11xx codes
- M1106The start of an episode of care documented in the medical record
- M1107Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care
- M1108Ongoing care not clinically indicated because the patient needed a home program only, referral to another provider or facility, or consultation only, as documented in the medical record
- M1109Ongoing care not medically possible because the patient was discharged early due to specific medical events, documented in the medical record, such as the patient became hospitalized or scheduled for surgery
- M1110Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)
- M1111The start of an episode of care documented in the medical record
- M1112Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care
- M1113Ongoing care not clinically indicated because the patient needed a home program only, referral to another provider or facility, or consultation only, as documented in the medical record
- M1114Ongoing care not medically possible because the patient was discharged early due to specific medical events, documented in the medical record, such as the patient became hospitalized or scheduled for surgery
- M1115Ongoing care not possible because the patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown)
- M1116The start of an episode of care documented in the medical record
- M1117Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson's diagnosed at any time before or during the episode of care
Common questions about M1162
Is HCPCS M1162 still valid?
- Yes. M1162 is active in the CMS October 2026 HCPCS file.
Does Medicare cover M1162?
- Its coverage code is "C": coverage is left to the Medicare contractor's judgment. Check the local coverage determination for your region.