M1162 HCPCS Level II code: Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patient's 13th birthday
M1162 is the HCPCS code for “Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patient's 13th birthday” in CMS’s October 2026 release, in effect from Oct 1, 2026.
Official description
M1162Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patient's 13th birthday
Short description: Pt enceph due to dtp bef 13
HCPCS · United States
Medicare details
The indicators CMS publishes with M1162 in its October 2026 file. They describe Medicare’s handling, not another payer’s.
- Medicare coverage
- Carrier judgment
- Medicare pricing
- Service not separately priced by Part B (e.g., services not covered, bundled, used by Part A only, etc.)
- Type of service
- Medical care
- BETOS category
- Undefined codes
- Added
- Jan 1, 2023
Where M1162 sits
- 1M codesMedical services and quality measures
- 2Active code M1162Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patient's 13th birthday
Source and release
- Data release
- HCPCS Level II · October 2026
- Effective date
- Oct 1, 2026
- Publisher
- CMS
This page is built from the HCPCS Level II catalog that Vero Codes reads when it suggests codes: Centers for Medicare & Medicaid Services’s October 2026 release, imported from the publisher’s file and checked against it. The description, notes and structured data come from the same record.
Frequently asked questions
What does HCPCS code M1162 mean?
M1162 is the HCPCS code for “Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patient's 13th birthday” in CMS’s HCPCS Level II October 2026 release.
Does Medicare cover M1162?
CMS lists M1162’s Medicare coverage as “Carrier judgment” and its pricing as “Service not separately priced by Part B (e.g., services not covered, bundled, used by Part A only, etc.)”. Coverage and payment still depend on the patient, the setting, the documentation and the payer.
Which HCPCS Level II release does this page use?
It uses CMS’s October 2026 release, in effect from Oct 1, 2026 to Dec 31, 2026. It is a reference: confirm the code against the current list and the payer’s rules before you submit it.
Codes beside M1162
All M codesM1156Patient received active chemotherapy any time during the measurement periodM1157Patient received bone marrow transplant any time during the measurement periodM1158Patient had history of immunocompromising conditions prior to or during the measurement periodM1159Hospice services provided to patient any time during the measurement periodM1160Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patient's 13th birthdayM1161Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patient's 13th birthdayM1163Patient had anaphylaxis due to the hpv vaccine any time on or before the patient's 13th birthdayM1164Patients with dementia any time during the patient's history through the end of the measurement periodM1165Patients who use hospice services any time during the measurement periodM1166Pathology report for tissue specimens produced from wide local excisions or re-excisionsM1167In hospice or using hospice services during the measurement periodM1168Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period