M1180 — Patients on immune checkpoint inhibitor therapy
M1180 is a HCPCS Level II code for patients on immune checkpoint inhibitor therapy. It belongs to the Medical Services section. Whether Medicare pays it depends on the coverage rule below.
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.
Physician fee schedule statusM
Measurement code. Used for reporting purposes only; never paid.
Global period: XXX
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The CMS record for M1180
- Long descriptor
- Patients on immune checkpoint inhibitor therapy
- Short descriptor
- Pt imm ckpt inhib therapy
- Added
- January 1, 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.
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 M1180
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If M1180 is not quite right, the correct code is very often within a few positions of it.
- M1172Documentation 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)
- 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 period
- M1174Patient 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
- M1175Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)
- M1176Patient 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
- M1177Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period
- M1178Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)
- M1179Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period
- M1181Grade 2 or above diarrhea and/or grade 2 or above colitis
- M1182Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohn's disease)
- M1183Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered
- M1184Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting diagnostic workup results for alternative etiologies, other medical reasons/contraindication)
- M1185Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given
- M1186Patients who have an order for or are receiving hospice or palliative care
- M1187Patients with a diagnosis of end stage renal disease (esrd)
- M1188Patients with a diagnosis of chronic kidney disease (ckd) stage 5
Questions about M1180
What is HCPCS code M1180?
M1180 is a HCPCS Level II code for patients on immune checkpoint inhibitor therapy. It sits in the Medical Services section.
Does Medicare cover M1180?
The CMS HCPCS file marks M1180 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.
How is M1180 paid under the physician fee schedule?
M1180 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.