HCPCS Level II M1446: Patient Death During Measure Assessment Period - OpenPayer

Summary & Overview

HCPCS Level II M1446: Patient Death During Measure Assessment Period

HCPCS Level II code M1446 denotes patients who died any time prior to the end of the measure assessment period. The code is used for administrative and quality-measure reporting to identify deaths that occur during a measurement window, ensuring accurate exclusion or classification of patients from performance measures and denominators. Nationally, consistent use of this code supports reliable quality measurement, mortality tracking in care episodes, and standardized reporting across settings. Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will learn what the code represents, how it is applied in measure reporting, and the implications for quality measurement and administrative records. The summary outlines where the code is typically recorded, common use cases in measurement workflows, and notes on data availability. Information on benchmarks, payer-specific application, claim-line usage, and related administrative guidance may be covered in accompanying sections. Data not available in the input for modifiers, associated taxonomies, ICD-10 diagnoses, related codes, and service line.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareM1446HCPCS Level IImortality reportingquality measurementadministrative codesmeasure exclusionsclinical documentationclaims processing

Billing Code Overview

HCPCS Level II code M1446 indicates patients who died any time prior to the end of the measure assessment period. This code is used to record that the patient expired during the measurement timeframe and is applied to the measure population to account for death as an exclusion or special case within quality and utilization assessments.

Service type: Administrative/outcome reporting derived from mortality status
Typical site of service: All settings where death may occur and be recorded during a measurement period, including inpatient, outpatient, emergency department, hospice, and post-acute settings

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A patient enrolled in a quality-measurement program dies during the measurement period. Typical workflow begins when a health system or payer runs end-of-period quality reports and identifies members flagged with measure denominators. Clinical staff review the medical record and administrative data to confirm the date of death and determine whether the death occurred prior to the end of the measurement period. Documentation sources include the electronic health record problem list, hospital discharge summary, death certificate, state mortality data, or obituary when available and validated. The coding or quality specialist assigns billing reason code M1446 to indicate the patient "died any time prior to the end of the measure assessment period," which affects denominator exclusions or final measure calculations. This code is used for retrospective administrative reporting, registry submission, and payer quality-appeal workflows. Typical sites of service include inpatient hospital settings, hospice, long-term care facilities, and medical office practices where the death was recorded. A realistic scenario: an 82-year-old patient with advanced congestive heart failure is admitted to the hospital, transitions to inpatient hospice, and passes away during the measurement year; the health system applies M1446 to exclude the patient from certain ongoing quality measure denominators for that reporting period.

Coding Specifications

Modifier	Description	When to Use
`GT`

HCPCS M1184: Documentation of Medical Reason for Not Prescribing Corticosteroid/Immunosuppressant

HCPCS-M1203-ACE-ARB-THERAPY-NOT-PRESCRIBED-REASON-NOT-GIVEN

HCPCS M1203: ACE inhibitor or ARB therapy not prescribed, reason not given

HCPCS-M1420-COMPLETE-OPHTHALMOLOGIC-CARE-MIPS-VALUE-PATHWAY

HCPCS M1420: Complete Ophthalmologic Care MIPS Value Pathway

HCPCS-M1331-RE-EVALUATION-WITHIN-8-WEEKS

HCPCS M1331: Re-evaluation Within Eight Weeks

HCPCS-M1165-HOSPICE-SERVICES-MEASUREMENT-PERIOD

HCPCS M1165: Hospice Services During Measurement Period

HCPCS-M1340-WHODAS-SDS-INDEX-ASSESSMENT

HCPCS M1340: 12-item WHODAS 2.0 or SDS Index Assessment

HCPCS-M1428-BILATERAL-ABSENCE-OF-EYES

HCPCS Level II M1428: Bilateral Absence of Eyes

HCPCS-M1251-PROXY-COMPLETED-HEALTH-SURVEY

HCPCS Level II M1251: Proxy-Completed Patient Health Survey

HCPCS-M1195-SURGICAL-PATHOLOGY-REPORT-MMR-MSI-TESTING-NOT-STATED

HCPCS M1195: Surgical Pathology Report Missing MMR/MSI Impression or Recommendation

HCPCS-M1367-ENT-QUALITY-CARE-MIPS-VALUE-PATHWAY

HCPCS M1367: Quality Care for ENT Disorders MIPS Value Pathway

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Taxonomy Code	Specialty	Notes
`207Q00000X`	Family Medicine	Primary care physicians routinely document deaths in outpatient and inpatient settings and participate in quality-measure reconciliation.
`207R00000X`	Internal Medicine	Hospitalists and internists manage inpatient deaths and contribute documentation used with `M1446` for measure exclusion.
`206E00000X`	Hospice and Palliative Medicine	Specialists who provide end-of-life care and certify hospice status, commonly involved when deaths occur under hospice care.
`207L00000X`	Emergency Medicine	Emergency physicians may document death in the ED and generate records used for reporting with `M1446`.
`174400000X`	Nursing Facility/Long Term Care	Facility-based providers or attending physicians in long-term care often document deaths for administrative and quality purposes.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z66`	Do not resuscitate	Indicates that resuscitation is not planned; commonly present in records of patients who die during the measurement period and informs exclusion decisions.
`I50.9`	Heart failure, unspecified	Heart failure is a frequent cause of death in older adults; documentation of mortality in these patients often leads to application of `M1446` in measure reporting.
`C80.1`	Malignant neoplasm, unspecified, without metastasis	Advanced malignancy with subsequent death during the measurement period is a common scenario for applying `M1446`.
`J96.00`	Acute respiratory failure, unspecified whether with hypoxia or hypercapnia	Acute respiratory decompensation leading to inpatient death is a scenario that generates records used for `M1446` coding.
`F03.90`	Unspecified dementia without behavioral disturbance	Dementia with terminal decline is a common end-of-life diagnosis where death during the measurement period may exclude patients from ongoing quality measures.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99221`	Initial hospital inpatient care, per day, for the evaluation and management of a patient, which requires a detailed or comprehensive history and examination and medical decision making of moderate complexity	Often performed prior to inpatient death; documentation supports timeline and reason for `M1446` reporting.
`99238`	Hospital discharge day management; 30 minutes or less	Used when discharge documentation is completed for patients who die in the hospital or when final summaries are generated prior to death reporting.
`99377`	Physician supervision of hospice care, per calendar month	Used for hospice-provided administrative and clinical services before a patient dies; supports hospice documentation for `M1446`.
`99499`	Unlisted evaluation and management service	Occasionally used for non-standard administrative services associated with end-of-life care documentation prior to assigning `M1446` in reporting workflows.
`99406`	Smoking and tobacco use cessation counseling visit, intermediate, greater than 3 minutes up to 10 minutes	Example of outpatient services that may have been provided earlier in the measurement period; included here to show clinical services documented prior to death that feed quality measures.

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