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View patient discharge status codes.
Medicare requires that when discharging a patient from an inpatient stay, the discharging facility reports the discharge disposition in the “Patient Discharge Status” field (FL 17). The claim must include the discharge status code that most accurately reflects the discharge of the patient.
The Centers for Medicare & Medicaid Services (CMS) requires patient discharge status codes for: Hospital Inpatient Claims (type of bills (TOBs) 11X and 12X); Skilled Nursing Claims (TOBs 18X, 21X, 22X and 23X);
Medicare pays these codes separately under the physician fee schedule (PFS), if covered. Codes with this status include RVUs and payment amounts. The presence of an A indicator doesn’t mean that Medicare has made a national coverage determination about the service.
In addition, a new patient discharge status code 70 was created in order for providers to be able to indicate discharges/transfers to another type of health care institution not defined elsewhere in the code list.
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 patient’s medical record supports the billed discharge status code. Billing the incorrect code may affect their ...
Guidance for use of the discharge status code to identify where patients are being discharged to at the end of their facility stay or transferred to. It clarifies that billing the incorrect code could affect payment. Issued by: Centers for Medicare & Medicaid Services (CMS) Issue Date: January 01, 2020.
This module introduces you to patient discharge status codes and hospital transfer policies. Upon completion of this module, you will be able to: Identify patient discharge status codes; Distinguish between acute care and post-acute care transfers ; Please click here to view this module.
Discharged/transferred to a nursing facility certified under Medicaid but not certified under Medicare. View patient status codes.
Frequently Used Status Codes; Patient Discharge Status Codes & Hospital Transfers ...