Clarification of Patient Discharge Status Codes and Hospital Transfer Policies - Make Your Revenue Smarter

MLN Matters Number: SE0801 Revised

Related Change Request (CR) #: N/A
Related CR Release Date: N/A
Effective Date: N/A
Related CR Transmittal #: N/A
Implementation Date: N/A

[The following is copied directly from this MLN Matters posting by CMS.]

Note: This article was revised on November 17, 2015, to add a reference to MLN Matters® Article SE1411. The link to SE1411 was previously removed until it could be updated. All other information is the same.

Provider Types Affected

Providers billing Medicare Fiscal Intermediaries (FIs) or Part A/B Medicare Administrative Contractors (A/B MACs).

Provider Action Needed STOP – Impact to You

This Special Edition article is based on information from the Centers for Medicare & Medicaid Services (CMS) regulations and transmittals and the National Uniform Billing Committee (NUBC) Official UB-04 Data Specifications Manual 2008 (Version 2.00 July 2007) Section Form Locator 17 (Patient Discharge Status) Effective Date: March 1, 2007 copyrighted by the American Hospital Association (AHA); NUBC UB-04 Version 2.00 Clarifications and Errata (as of 8/22/07). It provides clarifications and instructions on determining the correct patient discharge status code to use when completing your claims.

IMPORTANT: The NUBC is responsible for the maintenance and dissemination of guidance for the UB-04 code set. The CMS has provided a subset of information below for Medicare-participating providers. For greater detail, providers should visit http://www.nubc.org/ in order to purchase a UB-04 manual.

CAUTION – What You Need to Know

A patient discharge status code is a two-digit 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. It belongs in Form Locator 17 on a UB-04 claim form or its electronic equivalent in the HIPAA compliant 837 format.

GO – What You Need to Do

See the Background section of this article for more details regarding instructions and clarifications for patient discharge status coding.

Dowload the full article HERE. (PDF Format, 12 pgs, 129 KB)

 

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