0000092313 00000 n If this is a U.S. Government information system, CMS maintains ownership and responsibility for its computer systems. THE LICENSE GRANTED HEREIN IS EXPRESSLY CONDITIONED UPON YOUR ACCEPTANCE OF ALL TERMS AND CONDITIONS CONTAINED IN THIS AGREEMENT. discharge disposition codes 2021 hb```b``fa`2lx$e6~-Ud_I*ee^#}R hVc`@Yf,|@A4rDuD8*6cuPC>C[30 i) w=X`` ** Outpatient Hospital Claims (TOBs 13X, 14X, 71X, 73X, 74X, 75X, 76X and 85X); and 0000007548 00000 n What is discharge status code 03? For reporting other discharges/transfers to nursing facilities, providers should see codes 04 and 64. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL COVERED BY THIS LICENSE. 0000006647 00000 n Discharged/transferred to home with a written plan of care for home care services (tailored to the patients medical needs) whether home attendant, nursing aides, certified attendants, etc. 03 Discharged/Transferred to a Skilled Nursing Facility (SNF) with Medicare Certification in Anticipation of Skilled Care. ** Skilled Nursing Claims (TOBs 18X, 21X, 22X and 23X); 0000014725 00000 n There are times in which the various content contributor primary resources are not synchronized or updated on the same time interval. H|TM0WJ*a8viUi%]n)X*VLb;273~y[Lu. To license the electronic data file of UB-04 Data Specifications, contact AHA at (312) 893-6816. Patient discharge status Code 66 is used to identify a transfer to a critical access hospital (CAH) for inpatient care. 30 Still Patient or Expected to Return for Outpatient Services 2023 ICD-10-CM | CMS - Centers For Medicare & Medicaid Services ** All Hospice and Home Health Claims (TOBs 32X, 33X, 34X, 81X and 82X). This code should be reported when a patient is: Applications are available at the, Applicable Federal Acquisition Regulation Clauses (FARS)\Department of Defense Federal Acquisition Regulation Supplement (DFARS) Restrictions Apply to Government use. The same processes should be applied for patient discharge status codes as with any other coding. In cases in which two or more patient discharge status codes apply, providers should code the highest level of care known. Any questions pertaining to the license or use of the CPT must be addressed to the AMA. Race/Ethnicity: In 2021, 30,161 White patients were discharged to hospice, more than for other Race/Ethnicity groups. If the first hospital was unaware of the planned admission at the second hospital, its likely the first hospital will have to adjust the previously submitted claim to correct the patient discharge status code to indicate a transfer (02), which reflects where the patient was later admitted on the same date. .gov Patient Discharge Status Codes and Hospital Transfer Policies All rights reserved. ADA DISCLAIMER OF WARRANTIES AND LIABILITIES. Discharge Disposition code 2 - Patient discharged from agency (with formal assistive services). On September 26, 2019, the Centers for Medicare and Medicare Services (CMS) released the final rule on discharge planning requirements (the Final Rule) in an effort to empower patients to be active participants in the discharge planning process. No fee schedules, basic unit, relative values or related listings are included in CPT. Latham, NY 12110 The ADA is a third-party beneficiary to this Agreement. Home The discharge status code identifies where the patient is being discharged to at the end of their facility stay or transferred to such as an acute/post-acute facility. The discharging facility should ensure that documentation in the patients medical record supports the billed discharge status code. The NUBC has also clarified that this code should also be used when a patient is transferred to an inpatient psychiatric unit of a Veterans Administration hospital. There is no FY 2023 GEMs file. In an effort to better enable the collection of health-related social needs (HRSNs), defined as individual-level, adverse social conditions that negatively impact a persons health or healthcare, are significant risk factors associated with worse health outcomes as well as increased healthcare utilization, the Centers for Disease Control and Preventions (CDC) National Center for Health Statistics (NCHS) is implementing 42 new diagnosis codes into the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), for reporting effective April 1, 2023. To designate patients that are discharged/transferred to a nursing facility with neither Medicare nor Medicaid certification, or The fourth digit is indicative of the submission frequency, and should align with the Patient Discharge Status reported on the claim. The sole responsibility for the software, including any CDT and other content contained therein, is with (insert name of applicable entity) or the CMS; and no endorsement by the ADA is intended or implied. 0000001682 00000 n ( The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. This sdtc:dischargeDispositionCode SHOULD contain exactly [0..1] code, which SHOULD be selected from ValueSet 2.16.840.1.113883.3.88.12.80.33 NUBC UB-04 FL17-Patient Status 0000007040 00000 n 41 Expired in a Medical Facility, such as a hospital, SNF, ICF, or free-standing hospice; and CPT codes, descriptions and other data only are copyright 2002-2020 American Medical Association (AMA). It is important to select the correct Patient Discharge Status code. endstream endobj 813 0 obj <>/Outlines 24 0 R/Metadata 308 0 R/PieceInfo<>>>/Pages 307 0 R/PageLayout/OneColumn/OCProperties<>/OCGs[814 0 R]>>/StructTreeRoot 310 0 R/Type/Catalog/LastModified(D:20090710093708)/PageLabels 305 0 R>> endobj 814 0 obj <. CMS Manual System - Centers For Medicare https:// ). Inpatient rehabilitation facilities (or designated units) are those facilities that meet a specific requirement that 75% of their patients require intensive rehabilitative services for the treatment of certain medical conditions. The primary method to identify that the patient is still receiving care is the bill type frequency code (e.g., Frequency Code 2: Interim First Claim, or Frequency Code 3: Interim Continuing Claim) Bill types ending in 2 or 3 should be reported with patient status of 30. Webcms discharge disposition codes 2021oxford statistics phd. This code should not be used for home health services provided by a: else{document.getElementById("usprov").href="/web/"+"jeb"+"/help/us-government-rights";}, Advance Beneficiary Notice of Noncoverage (ABN), Cardiac and Pulmonary Rehabilitation Programs, Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS), Acute Inpatient Prospective Payment System (IPPS) Hospital, Comprehensive Outpatient Rehabilitation Facility (CORF), Fee-for-Time Compensation Arrangements and Reciprocal Billing, Outpatient Prospective Payment System (OPPS), Provider Appeal Requests - PRRB or Contractor Hearings, Provider Statistical and Reimbursement (PS&R) System, Documentation Requests: How, Who and When to Send, Medical Documentation Signature Requirements, Supplemental Medical Review Contractor (SMRC), Unified Program Integrity Contractor (UPIC), Provider Outreach and Education Advisory Group (POE AG), PECOS and the Identity and Access Management System, Provider Enrollment Reconsiderations, CAPs, and Rebuttals, click here to see all U.S. Government Rights Provisions, American Hospital Association Online Store, Discharged to home or self-care (routine discharge), Discharged/transferred to a short-term general hospital for inpatient care, Discharged/transferred to skilled nursing facility (SNF) with Medicare certification, Discharged/transferred to a facility that provides custodial or supportive care, Discharged/transferred to a designated cancer center or children's hospital, Discharged/transferred to home under care of organized home health service organization in anticipation of covered skilled care, Left against medical advice or discontinued care, Admitted as an inpatient to this hospital, Discharged/transferred to court/law enforcement, Expired in a medical facility (e.g., hospital, SNF, ICF, or free-standing hospice), Discharged/transferred to a federal health care facility, Hospice - medical facility (certified) providing hospice level of care, Discharged/transferred to a hospital-based Medicare approved swing bed, Discharged/transferred to an inpatient rehabilitation facility (IRF) including rehabilitation distinct part units of a hospital, Discharged/transferred to a Medicare certified long term care hospital (LTCH), Discharged/transferred to a nursing facility certified under Medicaid but not certified under Medicare, Discharged/transferred to a psychiatric hospital or psychiatric distinct part unit of a hospital, Discharged/transferred to a critical access hospital (CAH), Discharged/transferred to a designated disaster alternate care site (effective 10/1/13), Discharged/transferred to another type of health care institution not defined elsewhere in this code list, Discharged to home or self-care with a planned acute care hospital inpatient readmission (effective 10/1/13), Discharged/transferred to a short-term general hospital for inpatient care with a planned acute care hospital inpatient readmission (effective 10/1/13), Discharged/transferred to a skilled nursing facility (SNF) with Medicare certification with a planned acute care hospital inpatient readmission (effective 10/1/13), Discharged/transferred to a facility that provides custodial or supportive care with a planned acute care hospital inpatient readmission (effective 10/1/13), Discharged/transferred to a designated cancer center or children's hospital with a planned acute care hospital inpatient readmission (effective 10/1/13), Discharged/transferred to home under care of organized home health service organization in anticipation of covered skilled care with a planned acute care hospital inpatient readmission (effective 10/1/13), Discharged/transferred to court/law enforcement with a planned acute care hospital inpatient readmission (effective 10/1/13), Discharged/transferred to a federal health care facility with a planned acute care hospital inpatient readmission (effective 10/1/13), Discharged/transferred to a hospital-based Medicare approved swing bed with a planned acute care hospital inpatient readmission (effective 10/1/13), Discharged/transferred to an inpatient rehabilitation facility (IRF) including rehabilitation distinct part units of a hospital with a planned acute care hospital inpatient readmission (effective 10/1/13), Discharged/transferred to a Medicare certified long term care hospital (LTCH) with a planned acute care hospital inpatient readmission (effective 10/1/13), Discharged/transferred to a nursing facility certified under Medicaid but not certified under Medicare with a planned acute care hospital inpatient readmission (effective 10/1/13), Discharged/transferred to a psychiatric hospital or psychiatric distinct part unit of a hospital with a planned acute care hospital inpatient readmission (effective 10/1/13), Discharged/transferred to a critical access hospital (CAH) with a planned acute care hospital inpatient readmission (effective 10/1/13), Discharged/transferred to another type of health care institution not defined elsewhere in this code list with a planned acute care hospital inpatient readmission (effective 10/1/13). In addition, CMS has added a specific code for discharges related to disaster situations. 0000048794 00000 n Unauthorized or improper use of this system is prohibited and may result in disciplinary action and/or civil and criminal penalties. CMS Disclaimer In the past, HCAI adjusted the grouper and applied it to records based on a calendar year. 0000007191 00000 n License to use CPT for any use not authorized here in must be obtained through the AMA, CPT Intellectual Property Services, 515 N. State Street, Chicago, IL 60610. Discharged/transferred to home under care of organized home health service organization in anticipation of covered skilled care. CM MS-DRG Grouper - Codify Add On xref A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. CMS DISCLAIMER. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CDT. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product.