M1342 HCPCS: Mortality Reporting Reimbursement | OpenPayer

Summary & Overview

HCPCS Level II M1342: Patients Who Died During Performance Period

HCPCS Level II code M1342 denotes patients who died during a defined performance period and serves as a standardized marker for mortality capture across care settings. Nationally, consistent use of this code supports reporting, quality measurement, and administrative recordkeeping related to patient outcomes. It matters for hospitals, post-acute providers, hospice programs, and payers tracking mortality as an outcome or eligibility factor.

Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the code’s clinical meaning, typical sites of service, and service type. The publication also summarizes common payer coverage contexts and the range of modifiers that may accompany claims involving M1342. Additionally, the report outlines where this code fits in quality measurement and administrative reporting, and points to related coding and documentation considerations.

This overview is designed for national audiences involved in billing, coding, quality measurement, and clinical administration who need a clear, practical summary of HCPCS Level II code M1342 and its role in mortality reporting and performance-period outcome capture.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareM1342HCPCS Level IImortality reportingoutcome measurementperformance periodquality reportingservice documentation

Billing Code Overview

HCPCS Level II code M1342 reports patients who died during the performance period. This code is used to flag occurrences in which a patient death is recorded within the reporting or measurement interval. The service type for this code is mortality reporting / outcome capture. The typical site of service is any care setting where patient status and outcomes are tracked, including inpatient hospitals, long-term care facilities, hospice programs, and other clinical settings where performance or outcome measures are collected.

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A typical scenario involves an inpatient hospice, hospital, or long-term care facility reporting performance-period population measures that track patient outcomes. For billing code M1342 — "Patients who died during the performance period" — the workflow is administrative and quality-measure oriented rather than a billed clinical procedure. A patient admitted for advanced metastatic cancer or end-stage organ failure receives supportive care; during the reporting interval the patient expires. Clinical staff document the date and time of death, cause of death on the medical record, and update the problem list and discharge/death summary. Quality and population-health teams abstract the case to count the patient in the numerator for mortality-related performance measures. Typical sites of service are inpatient hospitals, skilled nursing facilities, hospice residences, and long-term acute care hospitals. Common actions in the workflow include confirming death, completing required death documentation (death summary, final progress note), notifying the medical examiner if applicable, updating the electronic health record, and submitting the case to the organization’s quality reporting or registry systems where M1342 is used to denote inclusion in the cohort of patients who died during the performance period.

Coding Specifications

Modifier	Description	When to Use
`22`

HCPCS M1458: Patient Died Prior to End of Performance Period

HCPCS-M1360-C-SSRS-SUICIDAL-IDEATION-BEHAVIOR-ASSESSMENT

HCPCS M1360: C-SSRS Suicidal Ideation and Behavior Assessment

HCPCS-M1276-BMI-OUTSIDE-NORMAL-NO-FOLLOW-UP-DOCUMENTED

HCPCS M1276: BMI Outside Normal Parameters, No Follow-Up Documented

HCPCS-M1228-HCV-TREATMENT-INITIATION-AFTER-VIREMIA

HCPCS M1228: HCV Treatment Initiation Within 3 Months of Reactive Antibody Test

HCPCS-M1308-INFLUENZA-IMMUNIZATION-NOT-ADMINISTERED

HCPCS Level II M1308: Influenza Immunization Not Administered

HCPCS-M1428-BILATERAL-ABSENCE-OF-EYES

HCPCS Level II M1428: Bilateral Absence of Eyes

HCPCS-M1485-HCV-NO-SUSTAINED-VIROLOGICAL-RESPONSE

HCPCS M1485: HCV No Sustained Virological Response

HCPCS-M1430-RETINAL-EXAM-NO-RETINOPATHY-BOTH-EYES-SEVERITY-DOCUMENTED

HCPCS M1430: Retinal Exam, No Retinopathy in Both Eyes with Severity Documented

HCPCS-M1421-DERMATOLOGY-MIPS-VALUE-PATHWAY

HCPCS Level II M1421: Dermatology MIPS Value Pathway

HCPCS-M1162-VACCINE-ASSOCIATED-ENCEPHALITIS-PEDIATRIC

HCPCS M1162: Encephalitis Due to Tetanus/Diphtheria/Pertussis Vaccine

Showing 1–10 of 356

Taxonomy Code	Specialty	Notes
`207P00000X`	Internal Medicine	Common primary attending specialty managing inpatient end-of-life care and documentation.
`208D00000X`	General Surgery	Performs emergent or planned procedures where intraoperative events may result in discontinued services coded with appropriate modifiers.
`207Q00000X`	Hospice and Palliative Medicine	Manages comfort-focused care and documentation for patients who die during the performance period.
`363A00000X`	Critical Care Medicine	Provides intensive care where deaths during the reporting period are commonly abstracted for quality measurement.
`367H00000X`	Anesthesiology	Provides anesthesia services that may require anesthesia-related modifiers when procedures are altered or stopped before death.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I50.9`	Heart failure, unspecified	Common terminal diagnosis in hospitalized patients who die during a performance period; often part of mortality cohorts.
`C80.1`	Malignant (primary) neoplasm, unspecified	Represents advanced cancer with high risk of death during the reporting interval and frequent inclusion in mortality measures.
`J96.00`	Acute respiratory failure, unspecified whether with hypoxia or hypercapnia	Frequently present in critically ill patients who expire and is relevant to coding events leading to death.
`N18.6`	End stage renal disease	Chronic condition associated with high mortality in inpatient populations included in performance-period death counts.
`A41.9`	Sepsis, unspecified organism	Acute, life-threatening infection commonly preceding in-period death in hospitalized cohorts.
`G30.9`	Alzheimer disease, unspecified	Advanced neurodegenerative disease commonly recorded for patients who die in long-term care or hospice.
`K74.6`	Other and unspecified cirrhosis of liver	End-stage liver disease contributing to mortality during the performance period.
`R99`	Ill-defined and unknown cause of mortality	Used in some situations when a definitive cause of death is not determined in the record prior to abstraction.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99223`	Initial hospital care, typically 70 minutes or more	Used for admission evaluation of critically ill patients who may later die during the performance period; documents initial complexity.
`99291`	Critical care, evaluation and management of the critically ill or injured patient; first 30-74 minutes	Captures critical care time provided before a patient’s death and is relevant to measures counting in-period mortality.
`99497`	Advance care planning including explanation and discussion of advance directives; first 30 minutes	Documents advance care planning conversations often performed in patients near end-of-life whose deaths are captured by `M1342`.
`99406`	Smoking and tobacco use cessation counseling intermediate, greater than 3 minutes up to 10 minutes	Example of preventive counseling services that may have been provided earlier in the performance period; included for workflow completeness when a patient dies during the period.
`11042`	Debridement; subcutaneous tissue, first 20 sq cm or less	Example of a procedure that could be partially completed or discontinued using modifiers if the patient dies during the performance period.
`40490`	Closure of laceration, extensive or complicated	Surgical procedure that may be discontinued or billed with assistant/surgical modifiers if interrupted prior to completion by patient demise.

OpenPayer