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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.

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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.

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

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Get alerted when payer policies referencing M1356 are released or updated.

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Billing Code Overview

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.
`23`	Unusual anesthesia	Use when general anesthesia is medically appropriate though usually contraindicated; uncommon for death event reporting but may apply to anesthesia services performed during the measurement period.
`52`	Reduced services	Use when a service is partially reduced or eliminated at the physician's discretion; may apply to procedures truncated prior to death.
`53`	Discontinued procedure	Use when a procedure is started but discontinued due to patient condition, including deterioration or death.
`54`	Surgical care only	Use for the surgeon's portion of a procedure when other components are billed separately prior to death.
`55`	Postoperative management only	Use when only postoperative care is billed because the operative portion was performed by another provider prior to death.
`56`	Preoperative management only	Use when only preoperative evaluation is billed and the patient did not proceed to surgery because of clinical decline or death.
`62`	Two surgeons	Use when two surgeons worked together as primary surgeons on a complex procedure performed during the measurement period.
`AS`	Physician assistant, surgical	Use when a physician assistant provides the service in a facility setting during the measurement period.
`QX`	Certified Registered Nurse Anesthetist (CRNA) service with medical direction by physician	Use when a CRNA performs anesthesia under physician direction; relevant for anesthesia services billed during the measurement period.

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.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
Data not available in the input.	Data not available in the input.	Data not available in the input.

Related CPT Codes

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.

Note: Specific CPT usage varies by clinical workflow; M1356 itself is an administrative quality-reporting code rather than a procedure code.

HCPCS Level II M1252: Ambulatory Palliative Care Patient Experience Survey Noncompletion

HCPCS-LEVEL-II-M1255-POSITIVE-PREGNANCY-TEST-NON-OB-VISIT

HCPCS Level II M1255: Positive Pregnancy Test During Non-Obstetric Clinic Visit

HCPCS-LEVEL-II-M1278-ELEVATED-BLOOD-PRESSURE-WITH-DOCUMENTED-FOLLOW-UP

HCPCS Level II M1278: Elevated Blood Pressure with Documented Follow-Up

HCPCS-LEVEL-II-M1292-FRAILTY-WITH-ADVANCED-ILLNESS-66-PLUS

HCPCS Level II M1292: Frailty with Advanced Illness in Patients 66+

HCPCS-LEVEL-II-M1300-INFLUENZA-IMMUNIZATION-NOT-ADMINISTERED

HCPCS Level II M1300: Influenza Immunization Not Administered

HCPCS-LEVEL-II-M1326-HYPOTONY-EVALUATION-MANAGEMENT

HCPCS Level II M1326: Patients with Diagnosis of Hypotony

HCPCS-LEVEL-II-M1375-RA-ADDITIONAL-ENCOUNTER-90-DAYS

HCPCS Level II M1375: Additional Rheumatoid Arthritis Encounter

HCPCS-LEVEL-II-M1384-PATIENTS-DIED-PERFORMANCE-PERIOD

HCPCS Level II M1384: Patients Who Died During Performance Period

HCPCS-LEVEL-II-M1490-PATIENT-STATUS-NOT-DOCUMENTED

HCPCS Level II M1490: Patient Status Not Documented

HCPCS-LEVEL-II-M1503-VASCULAR-SURGERY-MIPS-VALUE-PATHWAY

HCPCS Level II M1503: Vascular Surgery MIPS Value Pathway

Showing 1–10 of 356

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

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.
`23`	Unusual anesthesia	Use when general anesthesia is medically appropriate though usually contraindicated; uncommon for death event reporting but may apply to anesthesia services performed during the measurement period.
`52`	Reduced services	Use when a service is partially reduced or eliminated at the physician's discretion; may apply to procedures truncated prior to death.
`53`	Discontinued procedure	Use when a procedure is started but discontinued due to patient condition, including deterioration or death.
`54`	Surgical care only	Use for the surgeon's portion of a procedure when other components are billed separately prior to death.
`55`	Postoperative management only	Use when only postoperative care is billed because the operative portion was performed by another provider prior to death.
`56`	Preoperative management only	Use when only preoperative evaluation is billed and the patient did not proceed to surgery because of clinical decline or death.
`62`	Two surgeons	Use when two surgeons worked together as primary surgeons on a complex procedure performed during the measurement period.
`AS`	Physician assistant, surgical	Use when a physician assistant provides the service in a facility setting during the measurement period.
`QX`	Certified Registered Nurse Anesthetist (CRNA) service with medical direction by physician	Use when a CRNA performs anesthesia under physician direction; relevant for anesthesia services billed during the measurement period.

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.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
Data not available in the input.	Data not available in the input.	Data not available in the input.

Related CPT Codes

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.

Note: Specific CPT usage varies by clinical workflow; M1356 itself is an administrative quality-reporting code rather than a procedure code.

HCPCS Level II M1252: Ambulatory Palliative Care Patient Experience Survey Noncompletion

HCPCS-LEVEL-II-M1255-POSITIVE-PREGNANCY-TEST-NON-OB-VISIT

HCPCS Level II M1255: Positive Pregnancy Test During Non-Obstetric Clinic Visit

HCPCS-LEVEL-II-M1278-ELEVATED-BLOOD-PRESSURE-WITH-DOCUMENTED-FOLLOW-UP

HCPCS Level II M1278: Elevated Blood Pressure with Documented Follow-Up

HCPCS-LEVEL-II-M1292-FRAILTY-WITH-ADVANCED-ILLNESS-66-PLUS

HCPCS Level II M1292: Frailty with Advanced Illness in Patients 66+

HCPCS-LEVEL-II-M1300-INFLUENZA-IMMUNIZATION-NOT-ADMINISTERED

HCPCS Level II M1300: Influenza Immunization Not Administered

HCPCS-LEVEL-II-M1326-HYPOTONY-EVALUATION-MANAGEMENT

HCPCS Level II M1326: Patients with Diagnosis of Hypotony

HCPCS-LEVEL-II-M1375-RA-ADDITIONAL-ENCOUNTER-90-DAYS

HCPCS Level II M1375: Additional Rheumatoid Arthritis Encounter

HCPCS-LEVEL-II-M1384-PATIENTS-DIED-PERFORMANCE-PERIOD

HCPCS Level II M1384: Patients Who Died During Performance Period

HCPCS-LEVEL-II-M1490-PATIENT-STATUS-NOT-DOCUMENTED

HCPCS Level II M1490: Patient Status Not Documented

HCPCS-LEVEL-II-M1503-VASCULAR-SURGERY-MIPS-VALUE-PATHWAY

HCPCS Level II M1503: Vascular Surgery MIPS Value Pathway

Showing 1–10 of 356

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

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

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Billing Code Overview

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

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References