Patient Status Codes - JD DME
Patient Status Codes
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| Status | Definition |
|---|---|
| 01 | Discharged to home or self care |
| 02 | Discharged/transferred to short-term general hospital for Inpatient Care |
| 03 | Discharged/transferred to SNF with Medicare certification in anticipation of covered skilled care. Do not use this for transfers to a non-Medicare certified area. For Swing Beds see Code 61 below |
| 04 | Discharged/transferred to an Intermediate Care Facility e.g. non-certified SNF beds, State designated Assisted Living Facilities |
| 05 | Discharged/transferred to a designated cancer center or children's hospital |
| 06 | Discharged/transferred to home under care of organized home health service organization in anticipation of covered skilled care. Dsch/Trans to home with written plan of care, foster care facility with home care & under home health agency with DME |
| 07 | Left against medical advice or discontinued care. Patients who leave before triage or seen by physician |
| 08 | Reserved for National Assignment |
| 09 | Admitted as an inpatient to this hospital-only use on Medicare OP claims when services begin when those Medicare OP services are greater than 3 days prior to an admission |
| 20 | Expired -used only when the patient dies |
| 21 | Discharges or transfers to court/law enforcement; includes transfers to incarceration facilities such as jail, prison or other detention facilities. Effective 10/1/09 |
| 22-29 22 23 24 25 26 27 28 29 | Reserved for National Assignment |
| 30 | Still a patient or expected to return for outpatient services-used when billing for LOA days or interim bills. It can be used for both IP or OP claims, for IP claims the claim needs to be greater than 60 days |
| 31-39 31 32 33 34 35 36 37 38 39 | Reserved for National Assignment |
| 40 | Expired at home (Hospice claims only) used only on Medicare and TRICARE claims for hospice care |
| 41 | Expired in a medical facility (hospital, SNF, Intermediate Care Facility, or free standing hospice) for hospice use only |
| 42 | Expired - place unknown -this is used only on Medicare and TRICARE claims for Hospice only |
| 43 | Discharged/transferred to a Federal hospital Dept of Defense hospitals, VA hospitals, VA Psych unit or VA nursing facilities |
| 44-49 44 45 46 47 48 49 | Reserved for National Assignment |
| 50 | Discharged/transferred to Hospice (home)-or alternative setting that is the patient's home such as nursing facility, and will receive in-home hospice services |
| 51 | Discharged/transferred to Hospice medical facility- patient went to an IP facility that is qualified and the patient is to receive the general IP hospice level of care or hospice respite care. Used also if the patient is discharged from an IP acute care hospital to remain in hospital under hospice care |
| 52-60 52 53 54 55 56 57 58 59 60 | Reserved for National Assignment |
| 61 | Discharged/transferred within this institution to a hospital based Medicare approved swing bed. This is also used when discharged from an acute care hospital to a CAH swing bed |
| 62 | Discharged/transferred to an inpatient rehabilitation facility including distinct part units of a hospital |
| 63 | Discharged/transferred to a long term care hospital |
| 64 | Discharged/transferred to a nursing facility certified under Medicaid but not certified under Medicare. If the facility has some Medicare certified beds you should use patient status code 03 or 04 depending on the level of care the patient is receiving and if they are placed in a Medicare certified bed or not |
| 65 | Discharged/transferred to a psychiatric hospital or psychiatric distinct part unit of a hospital |
| 66 | Discharged/transferred to a Critical Access Hospital (CAH) |
| 67, 68 | Reserved for National Assignment |
| 69 | Discharged/transferred to a designated disaster alternative care site |
| 70 | Discharged/transferred to another type of health care institution not defined elsewhere in the code list |
| 71-80 | Reserved for National Assignment |
| 81 | Discharged to home or self-care with a planned acute care hospital inpatient readmission |
| 82 | Discharged/transferred to a short term general hospital for inpatient care with a planned acute care hospital inpatient readmission |
| 83 | Discharged/transferred to a skilled nursing facility (SNF) with Medicare certification with a planned acute care hospital inpatient readmission |
| 84 | Discharged/transferred to a facility that provides custodial or supportive care with a planned acute care hospital inpatient readmission |
| 85 | Discharged/transferred to a designated cancer center or children's hospital with a planned acute care hospital inpatient readmission |
| 86 | Discharged/transferred to home under care of organized home health service organization with a planned acute care hospital inpatient readmission |
| 87 | Discharged/transferred to court/law enforcement with a planned acute care hospital inpatient readmission |
| 88 | Discharged/transferred to a federal health care facility with a planned acute care hospital inpatient readmission |
| 89 | Discharged/transferred to a hospital-based Medicare approved swing bed with a planned acute care hospital inpatient readmission |
| 90 | Discharged/transferred to an inpatient rehabilitation facility (IRF) including rehabilitation distinct part units of a hospital with a planned acute care hospital inpatient readmission |
| 91 | Discharged/transferred to a Medicare certified long term care hospital (LTCH) with a planned acute care hospital inpatient readmission |
| 92 | Discharged/transferred to a nursing facility certified under Medicaid but not certified under Medicare with a planned acute care hospital inpatient readmission |
| 93 | Discharged/transferred to a psychiatric distinct part unit of a hospital with a planned acute care hospital inpatient readmission |
| 94 | Discharged/transferred to a critical access hospital (CAH) with a planned acute care hospital inpatient readmission |
| 95 | Discharged/transferred to another type of health care institution not defined elsewhere in this code list with a planned acute care hospital inpatient readmission |
Last Updated Thu, 18 Feb 2021 22:21:18 +0000