M1162 Pt enceph due to dtp bef 13
Also known as: DTP encephalopathy, vaccine-related brain inflammation
Patient has history of encephalopathy due to diphtheria, tetanus, pertussis vaccine before age 13.
In Plain Language
Brain inflammation from DTP vaccine; Serious vaccine reaction
Clinical Context
Documents contraindication to diphtheria-tetanus-pertussis vaccination due to prior encephalopathy (neurotoxic adverse event).
RVU Information
CPT M1162 does not have a physician work RVU assigned by CMS. Reimbursement for this code is determined by payer-specific fee schedules.
Billing & Documentation
M-codes cover quality measures and performance reporting. They are used in value-based care programs to track whether specific clinical actions were taken. Documentation must support that the measured action was performed or a valid exclusion applies.
Specialties
Frequently Asked Questions
What is CPT code M1162?
CPT M1162 (Pt enceph due to dtp bef 13) is a M Codes code. Patient has history of encephalopathy due to diphtheria, tetanus, pertussis vaccine before age 13.
Is M1162 covered by insurance?
M1162 is a temporary HCPCS code. Coverage varies by payer and may change when permanent codes are assigned. Documents contraindication to diphtheria-tetanus-pertussis vaccination due to prior encephalopathy (neurotoxic adverse event).
When is CPT M1162 used?
Documents contraindication to diphtheria-tetanus-pertussis vaccination due to prior encephalopathy (neurotoxic adverse event).
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.