Summary & Overview
HCPCS Level II M1362: Patients Who Died During the Measurement Period
HCPCS Level II code M1362 documents patients who died during the measurement period. As an outcome-class billing identifier, it is used for reporting, quality measurement, and administrative tracking across care settings. Nationally, accurate capture of mortality in measurement windows influences performance measurement, population health reporting, and program-level assessments.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical meaning, typical service contexts, and implications for measurement workflows. The publication outlines benchmark considerations where available, summarizes recent policy or programmatic uses of mortality indicators, and provides clinical context for how the code is applied in reporting workflows.
This summary is intended for clinicians, coders, compliance officers, and health policy analysts seeking a clear, national-level description of HCPCS Level II code M1362, its role in outcome measurement, and the areas of operational impact when mortality is recorded during a measurement period. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code M1362 indicates patients who died during the measurement period. This code is used to identify and document mortality outcomes captured within a defined reporting or measurement timeframe.
-
Service Type: Measurement/Outcome Tracking
-
Typical Site of Service: Administrative reporting and clinical records across inpatient and outpatient settings where mortality during the measurement period must be recorded.
Clinical & Coding Specifications
Clinical Context
A typical scenario involves a hospice, palliative care, or primary care clinician documenting a patient who died during the measurement period for quality reporting, registry submission, or claims adjudication. The patient is often an adult with advanced illness (for example, progressive metastatic cancer, end-stage heart failure, advanced chronic obstructive pulmonary disease, or severe dementia) whose death occurred in the hospital, hospice facility, nursing home, or at home under home health or hospice care. The clinical workflow includes verification of date and time of death in the medical record, completion of death certification or documentation in the electronic health record, notification of the medical examiner or coroner if required by local law, entry of the event into the quality measurement/reporting system, and submission of the appropriate administrative code M1362 on encounter or registry data to indicate death during the measurement period. Typical sites of service include inpatient hospital, hospice facility, skilled nursing facility, and home hospice. The scenario often involves coordination among attending physicians, hospice nurses, case managers, medical records staff, and coders to ensure accurate capture of the mortality event for performance measurement and reporting purposes.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when additional work beyond usual is documented and billable for an associated service (rarely applicable to mortality reporting but may apply to concurrent procedures billed separately). |