Summary & Overview

HCPCS Level II M1356: Patients Who Died During the Measurement Period

HCPCS Level II code M1356 denotes patients who died during the measurement period and is primarily used for mortality reporting in quality measures and administrative records. Nationally, accurate capture of mortality events affects quality assessments, program reporting, and population health metrics, making clear definition and consistent use of this code important across care settings. Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will find a concise explanation of what M1356 represents, the clinical and administrative contexts where it is applied, and common implications for reporting and measurement. The publication outlines expected service settings, typical use in quality measurement frameworks, and what is available or not available in the provided input. Benchmarks, payer coverage context, and relevant policy or coding guidance are summarized where available; if specific data elements are missing from the input, the text notes that those items are not available. The focus is national in scope and intended to inform coding, compliance, and reporting stakeholders about the role of M1356 in mortality event capture.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareM1356HCPCS Level IImortality reportingquality measurementservice line reportinginpatient mortalityhospice reportingclinical documentation

Billing Code Overview

HCPCS Level II code M1356 indicates patients who died during the measurement period. This code is used to identify occurrences of patient death captured for quality measurement or reporting purposes.

Service type: Mortality event reporting
Typical site of service: Inpatient hospital, long-term care facility, hospice, or other care settings where patient death may be recorded

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A typical patient scenario involves a patient enrolled in a quality measurement program who dies during the measurement period. The billing code M1356 is used for reporting the event of death in population health and quality measure datasets. In clinical workflow, the patient may have had multiple encounters with outpatient, inpatient, or hospice providers prior to death. Staff in the care management, quality, or coding departments confirm date of death from the medical record, hospital discharge summary, death certificate, or hospice records, then assign M1356 to indicate the patient deceased during the measurement period. This code is not tied to a specific procedure performed at time of death but is used for administrative and quality measurement attribution across settings such as acute care hospitals, home hospice services, long-term care facilities, and outpatient clinics. Typical documentation sources include physician notes, final discharge summaries, hospice certifications, and the official death certificate.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work required is substantially greater than usual for a reported service; rarely applicable to death reporting but may appear on concurrent procedural claims prior to death.

Taxonomy Code	Specialty	Notes
`207P00000X`	Internal Medicine	Primary care physicians often manage end-of-life care and document death for measurement reporting.
`207Q00000X`	Family Medicine	Family physicians provide continuity care and certify deaths occurring in outpatient or home settings.
`163W00000X`	Hospice and Palliative Medicine	Hospice clinicians directly manage patients at end of life and supply documentation used for `M1356`.
`208000000X`	Hospitalist Medicine	Hospitalists document inpatient deaths and contribute to administrative coding for quality measures.
`207R00000X`	Geriatric Medicine	Geriatricians frequently care for elderly patients who may die during the measurement period and produce relevant records.

CPT Code	Description	Relationship to This Procedure
`99223`	Initial hospital inpatient care, typically 70 minutes or more	Represents comprehensive inpatient evaluation and management services that may precede an inpatient death during the measurement period.
`99377`	Physician-directed home health care supervision, each 30 days (add-on)	Reflects care coordination for patients receiving home or hospice services prior to death.
`99339`	Domiciliary or rest home visit for the evaluation and management of a new or established patient	Used for visits to long-term care facilities where a patient may die during the measurement period.
`99377`	End of life care supervision codes (administrative)	Used in some workflows to document ongoing physician supervision of home hospice patients prior to death.
`99499`	Unlisted evaluation and management service	Used for reporting atypical or unlisted E/M services when standard codes do not describe care provided prior to death.

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