M1407 Patients Who Died During Follow-Up HCPCS Reimbursement | OpenPayer

Summary & Overview

HCPCS Level II M1407: Patients Who Died During Follow-Up

HCPCS Level II code M1407 denotes patients who died during the follow-up period and is used to capture mortality outcomes in clinical follow-up, registries, and administrative reporting. Nationally, consistent capture of mortality outcomes is important for quality measurement, clinical research, and longitudinal program evaluation. This code provides a standardized mechanism to flag deaths that occur after an index encounter or during a defined follow-up interval.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of how M1407 is applied in clinical and administrative workflows, descriptions of typical sites of service where the code is recorded, and a summary of common modifiers used with HCPCS Level II codes (modifiers listed in input). The publication addresses benchmarking and reporting implications relevant to national quality measurement and registry reporting, and highlights clinical context for why accurate mortality coding matters to longitudinal care coordination and outcomes assessment.

Data not available in the input for associated taxonomies, ICD-10 diagnoses, related codes, and service line.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareM1407HCPCS Level IImortality reportingfollow-up outcomesclinical registryquality measurementadministrative reporting

Billing Code Overview

HCPCS Level II code M1407 describes patients who died during the follow-up period. This code is used to record the outcome of patient mortality observed during a study, registry, or follow-up interval.

Service type: Outcome/status reporting derived from patient follow-up
Typical site of service: Administrative or clinical follow-up settings, including hospitals, outpatient clinics, registries, and research follow-up contacts

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A typical patient scenario involves a patient enrolled in a clinical registry or longitudinal outcomes study who passes away during the study follow-up period. For example, a 78-year-old man with advanced congestive heart failure enrolled in a heart-failure outcomes registry is followed with scheduled clinic visits, telephone checks, and periodic mortality ascertainment. During routine follow-up, registry staff confirm date and cause of death from hospital records and death certificate. The clinical workflow includes documentation of the death in the patient record, abstraction of the date and cause of death, notification of the treating clinicians, closure of active study interventions, and coding the outcome event for billing and registry reporting. Typical stakeholders include primary care physicians, treating specialists (e.g., cardiology, oncology), medical records staff, clinical research coordinators, and billing offices. The service type is an outcome/status report related to cohort follow-up and mortality ascertainment. The typical site of service is administrative/registry services coordinated from outpatient clinic or health system data management; confirmation may occur at hospital inpatient service or via medical examiner/coroner records.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when services required substantially greater work than typical for the activity (e.g., extensive death-certification documentation due to complications).

HCPCS M1283: Patient Screened for Tobacco Use, Identified as User

HCPCS-M1314-BMI-NOT-DOCUMENTED

HCPCS Level II M1314: BMI Not Documented, No Reason Given

HCPCS-M1288-DOCUMENTED-REASON-NOT-SCREENING-HIGH-BLOOD-PRESSURE

HCPCS M1288: Documented Reason for Not Screening or Recommending Follow-Up for High Blood Pressure

HCPCS-M1400-PATIENT-DEATH-DURING-FOLLOW-UP

HCPCS M1400: Patients Who Died During Follow-Up

HCPCS-M1348-PAM-SCORE-INCREASE-EXCELLENT

HCPCS M1348: Patient Activation Measure Increase, Excellent

HCPCS-M1427-BONE-SCAN-MEDICAL-JUSTIFICATION

HCPCS Level II M1427: Documentation of Medical Reason for Bone Scan

HCPCS-M1181-GRADE-2-OR-ABOVE-DIARRHEA-COLITIS

HCPCS M1181: Grade 2+ Diarrhea and/or Colitis

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

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

HCPCS-M1172-TD-TDAP-VACCINE-CONTRAINDICATION-DOCUMENTATION

HCPCS M1172: Documentation of Td/Tdap Vaccine Contraindication

HCPCS-M1147-ONGOING-CARE-DISCONTINUED-DUE-TO-HOSPITALIZATION-OR-SURGERY

HCPCS M1147: Ongoing Care Discontinued Due to Hospitalization or Surgery

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Taxonomy Code	Specialty	Notes
`208D00000X`	Cardiovascular Disease	Cardiology commonly involved in mortality ascertainment for cardiac registries.
`207Q00000X`	Internal Medicine	Primary care and hospitalists manage inpatient care and document death.
`207L00000X`	Emergency Medicine	Emergency physicians may certify death or provide documentation from acute events.
`208000000X`	General Surgery	Surgeons involved when perioperative deaths occur and require coding and documentation.
`363A00000X`	Clinical Laboratory Director	Pathology/lab specialists coordinate autopsy or postmortem testing documentation.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`R99`	Ill-defined and unknown cause of mortality	Used when death is documented but the precise cause is not determined at time of reporting.
`I50.9`	Heart failure, unspecified	Common primary condition in patients who die during heart-failure registries and follow-up.
`C80.1`	Malignant neoplasm, unspecified, with metastasis	Represents advanced cancer frequently encountered in mortality outcomes for oncology cohorts.
`J96.90`	Respiratory failure, unspecified, not otherwise specified	Often recorded as the immediate cause of death in acute hospitalizations.
`A41.9`	Sepsis, unspecified organism	Sepsis is a frequent terminal event leading to inpatient mortality and registry capture.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99223`	Initial hospital care, typically 70 minutes or more	May be billed for the treating physician’s initial hospital evaluation during the admission that culminated in death; documents clinical status before mortality ascertainment.
`99366`	Medical team conference with interdisciplinary team, per 30 minutes	May support multidisciplinary case review related to complex deaths and outcomes reporting.
`99499`	Unlisted evaluation and management service	Used when no specific CPT describes the administrative or registry services associated with mortality documentation.
`99090`	Collection and interpretation of physiologic data (e.g., ECGs), per 30 days	May be billed for monitoring services contributing to follow-up data prior to death in remote-monitoring registries.
`99080`	Special reports and forms, e.g., administration of official forms	May be used for completion of required death certification paperwork or registry-specific reporting forms.

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