For institutional claims, icd10 codes may be used only for diagnosis codes and inpatient procedure codes. A complete set of all data from the 2014 program year, which. Icd9cm vcodes factors influencing health status and contact with. We are actively responding to all phone and email inquiries.
Discharge status code 02 or 82 when an acute care hospital inpatient readmission is planned. Discharge edit codes tables discharge statusreferral. Together with the additional discharge information categories, the discharge status and disposition help to. Nov 23, 2016 patient discharge status codes and hospital transfer policies. Patient discharge status codes are part of the official ub04 data specifications manual and are used nationwide by institutional, private, and public providers, and payers of health care claims. The patient discharge status codes listed below is not an allinclusive list. Value codes were added as a new data element, please see page 48. Ub 04 medicare discharge status code cms 1500 claim form. Clarification of patient discharge status codes and hospital transfer policies ja0801. Na clarification of patient discharge status codes and hospital transfer policies ja0801 note. All hospital claims with an admit date on or after october 1, 2014, will require coding changes to delivery claims. Jan 07, 2016 in cases in which two or more patient discharge status codes apply, providers should code the highest level of care known.
As of 2015, the list of msdrgs impacted by the discharge status code has grown to 273. Patient discharge status codes and hospital transfer policies clarification october 24, 2014 a patient discharge status code is a twodigit code that identifies where the patient is at the conclusion of a health care facility encounter or at the end time of a billing cycle. Ipps final rule home page or acute inpatientfiles for download. Patient discharge status codes and hospital transfer. Clarification of patient discharge status codes and hospital. Manual replacement pages can be downloaded from the provider type pages on the provider. Data submissions are encouraged to be done on a monthly basis. The data elements and codes are developed and maintained by the national.
Snf and hha encounters that are submitted without a hipps code from dates july1, 2014. The first ed and as 63 dischargedtransferred to a medicare certified. Discharge edit codes tables discharge statusreferral disposition. Ja0801 was revised to update the web address on page 3 for accessing the list of designated cancer centers. Ub 04 medicare discharge status code,01 discharged to home or selfcare. It is important to select the correct patient discharge status code because it may affect your payment. California, hawaii, nevada, american samoa, guam, northern mariana islands. The chars procedure manual and chars companion guide supplement the national uniform billing committee uniform billing form 2004 nubc ub04 and the asc x12 standards for electronic data interchange technical report type 3, health care claim. Information on the inpatient clarification of patient discharge status codes and cms. Ahca discharge status codes new discharge status codes effective 100120 01 discharged to home or selfcare 81 homeself care w planned readmission 02 discharged or transferred to a shortterm general hospital 82 short term hospital w planned readmission 89 swing bed w planned readmission. Be advised that the file size, once downloaded, may still be prohibitive if. Dec 22, 2019 list of discharge status codes 2018 pdf download. Dataset downloads before you download some datasets, particularly. It is important to select the correct patient discharge status code because it.
In light of the evolving covid19 situation, we want to assure you that resdac remains open for business. Dischargedtransferred to a shortterm general hospital for. The center for medicare and medicaid services mln matters number. Patient discharge status codes and hospital transfer policies. Hospital discharge data vermont department of health. Discharge status uses the following permissible values. Condition codes were added as a new data element, page see page 32. There will be no grace period or dual use period for icd9 codes after october 1, 2014. The patient status code should contain the appropriate discharge status code. Facility discharge status codes pact policy update aapc. Special edition please see the list of the disposition codes on the next page.
May 28, 2015 as of 2015, the list of msdrgs impacted by the discharge status code has grown to 273. The day of discharge is never paid unless the member. Se0801 provides usage information on the correct patient discharge status codes for statedesignated and nonstatedesignated alfs, with an effective date of march 1, 2007. Medicare part a direct data entry dde first coast service updated june 1, 2015 of each provider to remain abreast of changes in the. Nextgen healthcare technical consulting product details. A patient discharge status code is a twodigit code entered into form locator fl 17 on the ub04 claim form that identifies the patients status at the conclusion of a health care facility encounter this could be a visit or an actual inpatient stay or at the time end of a billing cycle the. Transferred to a hospital or hospital unit that has not been officially determined as being excluded from pps such as. Duration and status of the patients stay in the hospital. This that update changed the reference for discharge code from 05. Together with the additional discharge information categories, the discharge status and disposition help to clarify the patients reason for dischar. Bcbsnc will be ready to process the icd10 codes on october 1, 2014 and will not accept icd10 codes before the october 1, 2014 implementation date.
Hipaa reference transaction setloop segment idcode valuereference. Inaccurate discharge status code assignments for medicare postacute care transfers. For fy2014, 15 new discharge status codes are added to the ms drg grouper logic for ms. Detailed examples of unknown, homeless and out of county patient addresses on pages 21 and 22. Key words se0801, discharge, status, hospital provider types. Medicare claims processing manual chapter 5 part b centers for 20. Caloms tx treatment data collection guide nna contract. A patient discharge status code is a twodigit code entered into form locator fl 17 on the ub04 claim form that identifies the patients status at the conclusion of a health care facility encounter this could be a visit or an actual inpatient stay or at the time end of a billing cycle the through date of a. This is a reminder to providers of the patient discharge status code requirements. A patient discharge status code is a twodigit code that identifies where the patient is at the conclusion of a health care facility encounter or at the end of a billing cycle the through date of a claim. Background the center for medicare and medicaid services mln matters number. Aug 2, 20 see the list below for a summary of the final weighted average of cms expects to make similar adjustments in fys 2015, 2016, and 2017 in order to add 15 new discharge status codes to the msdrg grouper. Encounter data submission and processing guide cssc operations. Ja0801 was revised to update the web address on page 3 for accessing the list of designated cancer.
But there is an additional code that often flies under the radarthe discharge status code. Clarification of patient discharge status codes and hospital transfer policies. Aarp health insurance plans pdf download medicare replacement pdf download medicare benefits pdf download medicare part b pdf download discharge status 71. If you cannot reach us directly via phone, please leave a voicemail and we will call you back. The patients living arrangements after discharge and the presence or absence of home health services if the patient is in a private home or apartment. The vermont uniform hospital discharge data system consists of inpatient.
Value codes were on april 1, 2014 the protecting access to medicare act of 2014 was signed into law. Facility discharge status codes pact policy update. Servicepaymentacuteinpatientppsacuteinpatientfilesfor download. An acute care hospital that would otherwise be eligible to be paid under the. Transfer pricing applies to the following discharge status codes. Patient discharge status codes identify where a patient is at the conclusion of a health care facility encounter or at the end of a billing cycle. Mvp will deny or reject claim lines when a patient discharge status code is invalid or missing. Ahca discharge status codes new discharge status codes effective 100120 01 discharged to home or selfcare 81 homeself care w planned readmission 02 discharged or transferred to a shortterm general hospital 82 short term hospital w planned readmission 89 swing bed w planned readmission 03 discharged or transferred to a skilled nursing facility 83 snf w planned readmission. Mar 15, 2017 clarification of patient discharge status codes and hospital transfer policies discharge status code 70 and a definition change to existing. The codes are grouped for wish wisconsin interactive statistics on health as shown in the table below.
Information on the inpatient clarification of patient discharge status codes. Clarification of patient discharge status codes and hospital transfer. Hospital patient discharge status wisconsin department. The patients living arrangements after discharge and the presence or absence of home health services if the patient is in a private. The patient discharge status code indicates the disposition or discharge status of the hospitalized patient. Microsoft excel has limitations on the number of records it can display, which this file exceeds. In the fy 2014 ippsltch pps proposed rule 78 fr 27516, we also proposed to add 15 new discharge status codes to the msdrg grouper logic for msdrgs 280, 281, and 282 that. If there was no admission assessment completed before discharge for a stay of. To download and install the latest version of the installer click the download link below.
Discharge disposition value set details centers for disease. Clarification of patient discharge status codes and hospital mar 15, 2018 clarification of patient discharge status codes and hospital transfer policies it is not intended to take the place of either the written law. Ncpdp october 2011 data dictionary, ncpdp april 2014 data dictionary. For these and other discharge codes, and for assistance in the proper reporting of patient discharge status, please refer to the national uniform billing committee. Servicepaymentacuteinpatientppsacuteinpatientfilesfordownload. Hospital patient discharge status wisconsin department of.
Discharge edit codes tables discharge statusreferral disposition referral disposition discharge status no referral made client not in need of additional services referred back to program in which patient is currently on census referred to less intensive level of treatment referred to more intensive treatment referred to same level. Assigning the correct patient discharge status code is just as important as any other coding used when filing a claim and the same processes should be applied for patient discharge status codes as with any other coding. Caloms tx data collection guide nna contract document 3j file version 2. New discharge dispositions were added, please see page 31 for new dispositions. Information on the inpatient cms manual system cms.
Sep 10, 2014 ahcccs implementation of aprdrg payments. Any time an institutional claim is submitted, the patient discharge status code must be. This manual is effective for data year 2015 issued in 2014. Clarification of patient discharge status codes and. A detailed description for each code may be found in wha information centers ub04 discharge status codes document. Florida department of environmental protection bureau of petroleum storage systems discharge cleanup status codes 03252020. Clarification of patient discharge status codes and hospital clarification of patient discharge status codes and hospital transfer policies.
Clarification of patient discharge status codes and cms. Mar 15, 2017 clarification of patient discharge status codes and hospital transfer policies. Clarification of patient discharge status codes and hospital cms. Discharge disposition sometimes called discharge status is the persons anticipated location or status. Msdrg codes where additional codes were available in october 20. It is a well known fact that icd9cm diagnosis and procedure codes impact hospital reimbursement and compliance. The items discharge status and discharge disposition allow you to record the clinical status of the patients treatment episode.