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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.

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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

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HCPCS Level II M1384: Patients Who Died During Performance Period

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Billing Code Overview

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
`23`	Unusual anesthesia	When general anesthesia is rendered under unusual circumstances related to emergent care preceding death
`52`	Reduced services	When a planned service was partially completed because the patient died before completion
`53`	Discontinued procedure	When a procedure was started but terminated due to patient death
`54`	Surgical care only	When postoperative care is not provided because patient expired during the performance period
`55`	Postoperative management only	When only postoperative management is performed prior to death
`56`	Preoperative management only	When only preoperative management occurred and patient died before the procedure
`62`	Two surgeons	When two surgeons were required but care was curtailed by patient death
`AS`	Ambulatory surgical center (facility)	When the episode started in an ASC and terminated due to death during the performance period
`CO`	Left or right laterality (example)	When laterality reporting is required in conjunction with services impacted by 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

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
`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

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-M1356-PATIENTS-WHO-DIED-DURING-MEASUREMENT-PERIOD

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

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

HCPCS Level II M1375: Additional Rheumatoid Arthritis Encounter

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

Frequently Asked Questions

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	When substantially greater work is performed beyond the usual service due to unexpected events prior to patient death
`23`	Unusual anesthesia	When general anesthesia is rendered under unusual circumstances related to emergent care preceding death
`52`	Reduced services	When a planned service was partially completed because the patient died before completion
`53`	Discontinued procedure	When a procedure was started but terminated due to patient death
`54`	Surgical care only	When postoperative care is not provided because patient expired during the performance period
`55`	Postoperative management only	When only postoperative management is performed prior to death
`56`	Preoperative management only	When only preoperative management occurred and patient died before the procedure
`62`	Two surgeons	When two surgeons were required but care was curtailed by patient death
`AS`	Ambulatory surgical center (facility)	When the episode started in an ASC and terminated due to death during the performance period
`CO`	Left or right laterality (example)	When laterality reporting is required in conjunction with services impacted by 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

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
`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

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-M1356-PATIENTS-WHO-DIED-DURING-MEASUREMENT-PERIOD

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

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

HCPCS Level II M1375: Additional Rheumatoid Arthritis Encounter

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

Frequently Asked Questions

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 M1384: Patients Who Died During Performance Period

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Billing Code Overview

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HCPCS Level II M1384: Patients Who Died During Performance 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

HCPCS Level II M1384: Patients Who Died During Performance Period

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Billing Code Overview

HCPCS Level II M1384: Patients Who Died During Performance Period

Sign up for hcpcs M1384 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does HCPCS code M1384 represent and when is it used?

What clinical documentation and workflow are required before applying M1384?

Which modifiers may be used with M1384 and why?

Is M1384 a payable clinical procedure and how does it relate to other codes?

Which payers are covered in the analysis for M1384 and does the page provide reimbursement rates?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does HCPCS code M1384 represent and when is it used?

What clinical documentation and workflow are required before applying M1384?

Which modifiers may be used with M1384 and why?

Is M1384 a payable clinical procedure and how does it relate to other codes?

Which payers are covered in the analysis for M1384 and does the page provide reimbursement rates?

References