Patient discharge status codes and hospital transfer policies. It is important to select the correct patient discharge status code because it may affect your payment. Specifications manual for joint commission national quality measures v2016a print this page. 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. To view a sample alp ub04 claim form, see appendix a. Dischargedtransferred to shortterm general hospital for inpatient care. This is the second article by gloryanne bryant on a subject that continues to raise questions and cause confusion. For status codes, please refer to the nubc ub04 manual. Nubc maintains lists of approved coding for the form.
Ub04nubc current ub data specifications manual ub04 fl17 patient status. Discha h rge our enter the time when the person was discharged. The hospice does not report occurrence code 42 on their claim. Nubcnucc meeting summaries public health data standards mar 16, 2010 year, nubc will draft a recommendation for oct 1, 2011. In 201112 chars transitioned to the 837 5010 file format.
The national uniform billing committee nubc approved a new patient discharge status code 20 expired, 40 expired at home, 41 expired in a change request 7473 cms. To assist in the proper coding of patient discharge status code, providers may access data elements, codes, and frequently asked questions by referring to the ub04 data specifications manual. This manual, ed by the american hospital association, is the only. See chapter 9 of the medicare benefit policy manual for hospice eligibility. The data elements and codes are developed and maintained by the national uniform billing committee nubc. The revision date and code sources, the national uniform billing committee nubc, or from make sure the entry. Racs and patient status, discharge disposition codes part. Racs and patient status, discharge disposition codes part ii. Masshealth billing guide for the ub04 executive office of.
To report hh visits on episodes beginning on or after january 1, 2011, the hha. Ub04nubc current ub data specifications manual ub04 fl17 patient status version. Aha ed materials including the ub04 codes and descriptions may not. The national uniform billing committee nubc makes their ub04 manual as situational in an implementation guide and are accessed by visiting the. Now it appears that discharge status is to be used for the. Aug 1, 2011 per the nubc, the point of origin for admission or visit code is. The chars companion guide and procedure manual supplement the asc x12 standards for.
New revenue code 0815 for allogeneic stem cell acquisition services created by the national uniform billing committee nubc, will be. Nubc patient status ub04 data specifications manual. Alp providers who choose to submit their claims on paper forms must use the national uniform billing committee nubc ub04 claim form. In 2011 12 chars transitioned to the 837 5010 file format and october 1, 2014 with the united states will move to icd10 codes. Inpatient psychiatric quality reporting ipfqr program. Ub 04 medicare discharge status code cms 1500 claim form.
Point of origin and discharge status codes for designated disaster alternate care sites. National uniform billing committee nubc uniform bill. New condition code for language other than english lote o explore the use of that external code list can\t be used in an x12 standard until new versions. A patient is discharged from our facility disposition code 01 and is to go to a doctors appointment the same day. Summary of 4111 ami and hf manual revisions page 1 of 4 updated. Clarification of patient discharge status codes and cms. Hospitals and providers are manual, appendix a survey protocol, regulations and interpretive guidelines for national uniform billing committee nubc, effective april 1, 2004, that specifies. The values for discharge status are taken from the national uniform billing committee nubc manual which is used by the billinghim to complete the ub04. We are recommending using the references distributed by the national uniform billing committee nubc official ub04 data specifications manual. October 1, 2011 for the 2012 cap year and subsequent cap years. The provider enters the code indicating the source of the referral. Nubc created a new patient discharge code to define discharges or transfers to courtlaw. Hospital discharge data system user manual august 2018 5 background in 1975, the american hospital association aha brought the national uniform billing committee nubc together to develop a single billing form and standard dataset that could be used nationwide by institutional providers and payers for handling healthcare claims.
Because this data element is critical in determining the population for many measures, the abstractor should not assume that the ub04 value is what is reflected in the medical record. Fact sheet summary of acute myocardial infarction and. This discharge claim will terminate the beneficiarys current hospice benefit period as of the through date on the claim. This data specifications manual is available from the national. Jan 23, 2008 assigning the correct patient discharge status code is just as important choosing the patient discharge status code correctly avoids claim errors new patient discharge status code 70 per nubc, effective april 1, 2008. National uniform billing committee nubc uniform bill patient discharge status codes provides a set of patient status codes used for patient billing to be included in discharge status messages. Locator 17 patient discharge status 01 discharged 30 still patient 41 expired in a medical facility. This patient discharge status code should be used whenever the destination at discharge is a federal health care facility, whether the patient resides there or not. Please use the following link to read the complete patient discharge status faqs from nubc. National uniform billing committee nubc, will be accepted into the. Admission type code 9 and admission source code 9 are not allowed. New york state ub04 billing guidelines version 2011 01 61 2011. Instead, the hospice reports condition code h2 to indicate a discharge for cause.
New patient discharge status code 21 to define discharges or transfers to courtlaw enforcement. Highmark blue shield billing highlights june 2011 snf outpatient. Point of origin and discharge status codes for designated disaster alternate care. Any nubc approved patient status code may be used in these cases. I believe this change was due to the fact that use of national uniform billing committee nubc elements requires that we pay royalty fees. June 2011 snf outpatient page 1 of 3 skilled nursing facility. Fis shall not this code is for uniform use by state uniform billing committees. Do not use this for transfers to a nonmedicare certified area. 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. Clarification of patient discharge status codes and hospital transfer policies ja0801. The patient status code set is defined by the nubc. Dischargedtransferred to snf with medicare certification in anticipation of covered skilled care.
To license the electronic data file of ub04 data specifications, contact aha at 312 8936816. R2250cp 07012011 nonsystems internet only manual iom. Ushik home the united states health information knowledgebase ushik contains information from numerous healthcarerelated initiatives. This cr provides implementing instructions for a new patient discharge. Patient status enter a code to indicate the disposition or discharge status of the patient at the end of the period covered by this claim. This manual, ed by the american hospital association, is the only official source of ub data. Patient status at discharge specifications manual for joint commission national quality measures v2016a. Back in 2011 cms removed discharge status as a data element replacing it with discharge disposition. All apr drg claims must include the discharge date regardless of the status code of the member. Jul 29, 2011 is received with any discharge status code other than 30. California, hawaii, nevada, american samoa, guam, northern mariana islands. New patient discharge status codes on ub04 claim form. Do you have general guidelines for reporting patient discharge status. The ub04 manual is available at form locators in this manual for.
Apr 1, 2004 national uniform billing committee nubc and to add all nubc additionally, all codes that have been approved by the nubc and that se1117 cms. West virginia hospital inpatient data system data element specifications guide february 7, 2011 page 1 introduction the west virginia hospital inpatient data system wvhids collects, processes, and analyzes inpatient discharge data that are collected by the west virginia health care authority wvhca. The ub04 data specifications manual is the official source of data specifications adopted by the nubc and contains codes used in the 837 institutional electronic claims. Origin for admission or visit codes to the ub04 cms1450 manual code list. Enter the four digit code that identifies the specific type status as of the through date. The nubc has also clarified that this code should also be used when a patient is transferred to an. Ushik content includes administered items and other artifacts for cms quality reporting programs, allpayer claims databases, childrens ehr format, draft clinical quality measures available for feedback, ahrqs patient safety common formats, as well as. Welcome to the newly redesigned website of the national uniform billing committee. Nov 2, 2007 meeting nubc has redefined the patient discharge status code 05 to indicate a. Patient discharge status code reporting a discharge occurs when a medicare beneficiary leaves an acute care hospital after receiving acute care treatment. See nubc official ub04 manual for additional codes.
This code indicates the patients discharge status as of the. Numerous and significant changes have been made to the ub04 manual from 2011 through 2017. Billing highlights skilled nursing facility part b. Dataelem0247 manual performance measurement network.
National uniform billing committee nubc official ub04 data specifications manual. Status are taken from the national uniform billing committee nubc manual which. Change to all measure sets discharge status has been changed to discharge disposition. Ja0801 was revised to update the web address on page 3 for accessing the list of designated cancer. It is a refresher from the provider billing manual. Clarification of patient discharge status codes and. The chars procedure manual and chars companion guide supplement the national uniform billing committee uniform billing form 2004 nubc ub04 and the asc x12.