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Part A UB-04 Discharge Status Codes (Form Locator 17)

A patient discharge status code is required on all Part A hospital and Skilled Nursing Facility (SNF) claims to indicate the patients status as of the through date of the billing period. The following list is not an all-inclusive list. Institutional billing codes are available from the National Uniform Billing Committee (NUBC) via the NUBCs Official UB-04 Data Specifications Manual. http://www.nubc.org/ Note: The Common Working File (CWF) has the following edits in place for inpatient hospital claims to ensure accurate coding and payment for discharge and/or transfer policies. Hospital claims reject when: A home health claim is submitted within three days of the discharge date of a hospital claim that contains a patients discharge status code other than 06. A SNF claim is submitted within 14 days of the discharge date of a hospital claim that contains a patients discharge status code other than 03. Code 01 02 03 04 05 06 07 09 20 21 30 Structure Discharged to home or self-care (routine discharge). Discharged/transferred to another short-term general hospital for inpatient care. Discharged/transferred to a Skilled Nursing Facility (SNF) with Medicare certification in anticipation of covered skilled care. Discharged/transferred to a facility that provides custodial or supportive care. Discharged/transferred to a designated cancer center or childrens hospital. Discharged/transferred to home under care of organized home health service organization in anticipation of covered skilled care. Left against medical advice or discontinued care. Admitted as an inpatient to this hospital. Note: Only applies to services that began greater than three days prior to an admission or that were unrelated to the reason for admission. Expired (or did not recover religious non-medical health care patient). Discharged/transferred to court/law enforcement. Still patient or expected to return for outpatient services.

Published March 2012 AS

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Code

Structure Discharged/transferred to a federal health care facility. Note: Applies to discharges and transfers to a government-operated health care facility, such as a Department of Defense hospital or a Veterans Affairs (VA) hospital or nursing facility, regardless of whether the patient lives there. Discharged/transferred to hospice home (inpatient only). Discharged/transferred to hospice medical facility (inpatient only). Discharged/transferred within this institution to a hospital-based Medicareapproved swing bed. Discharged/transferred to an inpatient rehabilitation facility, including distinctpart units of a hospital. Discharged/transferred to a Long-Term Care Hospital (LTCH). Discharged/transferred to a nursing facility certified under Medicaid but not certified under Medicare. Discharged/transferred to a psychiatric hospital or psychiatric distinct-part unit of a hospital. Discharged/transferred to a Critical Access Hospital (CAH). Discharged/transferred to another type of health care institution not defined elsewhere in the code list.

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50 51 61 62 63 64 65 66 70

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