M1172 – Documentation 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 after a previous dose of a td-containing vaccine)
HCPCS Level II code · M codes: Medical Services and Quality Measures
HCPCS codeM1172
- Long description
- Documentation 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 after a previous dose of a td-containing vaccine)
- Short description
- Doc med rsn no td/tdap
- Pricing indicator
00Not separately priced by Part B (bundled, not covered or Part A only)- Medicare coverage
CCarrier judgment – coverage decided by the Medicare contractor- BETOS category
Z2Undefined codes- Added
- January 1, 2023
- Last change
- January 1, 2023 – No change
Frequently asked questions
What is HCPCS code M1172?
M1172 is a HCPCS Level II code for documentation 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 after a previous dose of a td-containing vaccine).
Does Medicare cover M1172?
The HCPCS file lists coverage code C: Carrier judgment – coverage decided by the Medicare contractor. Coverage and payment also depend on local coverage determinations and the patient’s plan.
Nearby M codes
- M1164 – Patients with dementia any time during the patient's history through the end of the measurement period
- M1165 – Patients who use hospice services any time during the measurement period
- M1166 – Pathology report for tissue specimens produced from wide local excisions or re-excisions
- M1167 – In hospice or using hospice services during the measurement period
- M1168 – Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period
- M1169 – Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)
- M1170 – Patient 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 period
- M1171 – Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period
- M1173 – Patient 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 period
- M1174 – Patient 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 period
- M1175 – Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)
- M1176 – Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period
- M1177 – Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period
- M1178 – Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)
- M1179 – Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period
- M1180 – Patients on immune checkpoint inhibitor therapy
Source: CMS HCPCS Level II quarterly file, October 2026. Reference only – check payer policy before billing.