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 Fri, 30 Oct 2020 18:36:47 +0000