Point of Origin Codes

The provider must enter the code indicating the source of the referral for an admission or visit. Required except for Bill Type 014X, (the bill type is used for non-patient laboratory specimens and the point of origin would not be known).

Code Structure

Visit Code Point of Origin Inpatient/Outpatient
1 Non-Health Care Facility Point of Origin (Physician Referral)

Usage note: Includes patients coming from home, a physician's office, or workplace.
Inpatient: Patient was admitted to this facility upon an order of a physician.

Outpatient: Patient presents to this facility with an order from a physician for services or seeks scheduled services for which an order is not required (e.g., mammography). Includes non-emergent self-referrals.
2 Clinic or Physician's Office Inpatient: Patient was admitted to this facility.

Outpatient: Patient presented to this facility for outpatient services.
4 Transfer from a Hospital (different facility).

Usage Note: Excludes Transfers from Hospital Inpatient in Same Facility (See Code D)
Inpatient: Patient was admitted to this facility as a hospital transfer from an acute care facility where he or she was an inpatient or an outpatient.

Outpatient: Patient was referred to this facility for outpatient or referenced diagnostic services by a physician of a different acute care facility. * For transfers from hospital inpatient in the same facility, see code D.
5 Transfer from a SNF, ICF, ALF, or NR Inpatient: Patient was admitted to this facility as a transfer from a Skilled Nursing Facility (SNF), Intermediate Care Facility (ICF), Assisted Living Facility (ALF) or Nursing Facility (NF) where he or she was a resident.

Outpatient: Patient was referred to this facility for outpatient or referenced diagnostic services by a physician of the SNF, ICF, ALF or NF where he or she was a resident.
6 Transfer from another Health Care Facility Inpatient: Patient was admitted to this facility as a transfer from another type of health care facility not defined elsewhere in this code list.

Outpatient: Patient was referred to this facility for services by (a physician of) another health care facility not defined elsewhere in this code list where he or she was an inpatient or outpatient.
8 Court/Law Enforcement

Usage Note: Includes transfers from incarceration facilities
Inpatient: Patient was admitted to this facility upon the direction of a court of law, or upon the request of a law enforcement agency representative.

Outpatient: Patient was referred to this facility upon the direction of a court of law, or upon the request of a law enforcement agency representative for outpatient or referenced diagnostic services.
9 Information Not Available Inpatient: Patient reason for admission is not known. Not defined elsewhere.

Outpatient: Where the patient came from is unknown. Not defined elsewhere.
A - C Reserved  
D Transfer from One Distinct Unit of the Hospital to Another Distinct Unit of the Same Hospital

Usage Note: Results in a Separate Claim to Payer
Inpatients: Patient was admitted to this facility as a transfer from hospital inpatient within this hospital resulting in a separate claim to the payer.

Outpatients: Patient received outpatient services in this facility as a transfer from within this hospital resulting in a separate claim to the payer. For purposes of this code, "distinct unit" is defined as a unique unit or level of care at the hospital requiring the issuance of a separate claim to the payer. Examples could include observation service, psychiatric units, rehabilitation units, a unit in a critical access hospital, or a swing bed located in an acute hospital.
E Transfer from Ambulatory Surgery Center (ASC) Inpatient: Patient was admitted to this facility as a transfer from an ASC.

Outpatient: Patient came for outpatient or reference diagnostic services from an ASC.
F Transfer from Hospice Facility Inpatient: Patient admitted as a transfer from a hospice facility. Patient is under a hospice plan of care or enrolled in a hospice program.

Outpatient: Patient came for outpatient or reference diagnostic services from a hospice. Patient is under a hospice plan of care or enrolled in a hospice program.
G-Z Reserved  

 

Last Updated Fri, 03 Nov 2017 16:04:34 +0000