M1158 — Patient had history of immunocompromising conditions prior to or during the measurement period
M1158 is a HCPCS Level II code for patient had history of immunocompromising conditions prior to or during the measurement period. It belongs to the Medical Services section. It was terminated on December 31, 2023 and is not valid on new claims.
This code has been terminated
CMS terminated M1158 on December 31, 2023. It stays in the file as history — a claim you are auditing from before that date may legitimately carry it — but it must not appear on a new claim. The adjacent codes below are the usual place to look for its replacement.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
The CMS record for M1158
- Long descriptor
- Patient had history of immunocompromising conditions prior to or during the measurement period
- Short descriptor
- Pt hx immcomp prior/dur pd
- Added
- January 1, 2023
- Terminated
- December 31, 2023
- BETOS
- Z2
- Pricing indicator
- 00 — Not priced by Part B
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
When CMS retired it.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.
Codes adjacent to M1158
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If M1158 is not quite right, the correct code is very often within a few positions of it.
- M1150Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function
- M1151Patients with a history of heart transplant or with a left ventricular assist device (lvad)
- M1152Patients with a history of heart transplant or with a left ventricular assist device (lvad)
- M1153Patient with diagnosis of osteoporosis on date of encounter
- M1154Hospice services provided to patient any time during the measurement periodterminated
- M1155Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement periodterminated
- M1156Patient received active chemotherapy any time during the measurement periodterminated
- M1157Patient received bone marrow transplant any time during the measurement periodterminated
- M1159Hospice services provided to patient any time during the measurement period
- M1160Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patient's 13th birthday
- M1161Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patient's 13th birthday
- M1162Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patient's 13th birthday
- M1163Patient had anaphylaxis due to the hpv vaccine any time on or before the patient's 13th birthday
- M1164Patients with dementia any time during the patient's history through the end of the measurement period
- M1165Patients who use hospice services any time during the measurement period
- M1166Pathology report for tissue specimens produced from wide local excisions or re-excisions
Questions about M1158
What is HCPCS code M1158?
M1158 is a HCPCS Level II code for patient had history of immunocompromising conditions prior to or during the measurement period. It sits in the Medical Services section.
Does Medicare cover M1158?
The CMS HCPCS file marks M1158 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
Is M1158 still valid?
No. M1158 was terminated on December 31, 2023 and should not be used on new claims.