M1169 HCPCS Level II code: Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)
M1169 is the HCPCS code for “Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)” in CMS’s October 2026 release, in effect from Oct 1, 2026.
Official description
M1169Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)
Short description: Doc med rsn no flu vax
HCPCS · United States
Medicare details
The indicators CMS publishes with M1169 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 M1169 sits
- 1M codesMedical services and quality measures
- 2Active code M1169Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)
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 M1169 mean?
M1169 is the HCPCS code for “Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)” in CMS’s HCPCS Level II October 2026 release.
Does Medicare cover M1169?
CMS lists M1169’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 M1169
All M codesM1163Patient 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 periodM1170Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement periodM1171Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement periodM1172Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days…M1173Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement periodM1174Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement periodM1175Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)