Summary & Overview

HCPCS Level II M1384: Patients Who Died During Performance Period

HCPCS Level II code M1384 identifies patients who died during a defined performance period. This outcome-focused code is important for program-level reporting, quality measurement, and performance assessments across healthcare settings where mortality is a tracked endpoint. Nationally, consistent use of M1384 supports standardized reporting of deaths during measurement windows, informing quality programs, regulatory reporting, and population health analyses.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines how M1384 is applied in clinical and administrative workflows, addresses reporting implications for major payers, and summarizes common operational considerations tied to mortality capture.

Readers will learn the clinical context and service settings associated with M1384, the national significance for quality and performance measurement, and what to expect when this code appears on service records. Content includes benchmark-oriented perspectives, relevant policy and reporting considerations, and practical notes on where this code is typically recorded. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareM1384HCPCS Level IImortalityperformance measurementend-of-life reportingquality reportinginpatienthospice

Billing Code Overview

HCPCS Level II code M1384 denotes patients who died during the performance period. This code is used to indicate mortality among patients attributed to a program, service line, or performance measurement interval.

Service type: End-of-life outcome reporting and mortality capture
Typical site of service: Inpatient settings, hospice, and other sites where patient death may occur during a performance period

Clinical & Coding Specifications

Clinical Context

A typical patient scenario involves a patient who dies during an active performance period for episode-based or bundled payment reporting. Example: a 78-year-old patient admitted for advanced congestive heart failure with multi-organ failure who expires on hospital day 6 while enrolled in a 90-day bundled payment episode for heart failure management. Clinical workflow: the care team documents death in the medical record, completes the discharge summary and death certificate, notifies the coder/billing team, and closes the episode of care. Billing staff apply the M1384 HCPCS Level II code to indicate the patient died during the performance period, attach relevant modifiers if applicable, and ensure linkage to the primary diagnosis code(s) and facility claim. Medical record must include time/date of death, cause of death, and supporting clinical notes (progress notes, family notification, orders at time of death). Typical sites of service include acute inpatient hospital units, skilled nursing facilities, hospice inpatient units, and long-term acute care hospitals. Typical service type is an administrative reporting indicator used for episode-of-care or quality reporting rather than a billable therapeutic procedure.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	When substantially greater work is performed beyond the usual service due to unexpected events prior to patient death

Taxonomy Code	Specialty	Notes
`282N00000X`	Clinical Nurse Specialist	Often documents and coordinates end-of-life inpatient care and documentation
`207RC0000X`	Internal Medicine	Primary inpatient physicians managing complex medical patients who may expire during an episode
`208000000X`	Hospitalist	Commonly provides daily inpatient management and documents death in the hospital setting
`183P00000X`	Palliative Care Medicine	Provides end-of-life symptom management and documentation when death occurs during a performance period
`3356C0002X`	Hospice and Palliative Medicine	Manages hospice episodes and documents deaths for reporting

CPT Code	Description	Relationship to This Procedure
`99221`	Initial hospital care, typically 30 minutes	May have been provided at admission earlier in the episode before the patient died
`99238`	Hospital discharge day management, 30 minutes	Used to document discharge summary processes; when death occurs, similar documentation (discharge by death) is required
`99497`	Advance care planning including explanation and discussion of advance directives, first 30 minutes	Often performed in the episode prior to death for goals-of-care discussions
`92950`	Cardiopulmonary resuscitation (CPR)	May have been attempted during a cardiorespiratory arrest prior to patient death
`99024`	Postoperative follow-up visit, normally included in global service	If post-op care was curtailed by death, this code is relevant to auditing service days

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