There are 16 new discharge status codes which went into effect 10/1/13. At this time, they apply only to MS-DRGs 280 (Acute Myocardial Infarction, Discharged Alive with MCC), 281 (Acute Myocardial Infarction, Discharged Alive with CC), 282 (Acute Myocardial Infarction, Discharged Alive without CC/MCC) and 789 (Neonates, Died or Transferred to Another Acute Care Facility).
The first new code is 69 (Discharged/transferred to a designated disaster alternative care site). This code is intended to identify patients being discharged or transferred to an alternative site that will provide basic patient care during a disaster response. This new status code does not impact the transfer policy.
The remaining 15 new discharge status codes are related to a planned acute care hospital inpatient readmission. Currently, the purpose of the new codes is to allow providers to track these types of situations when they occur. These new status codes (81-95) have been mapped to their non-planned readmission counterparts and are included in the transfer policy. According to meeting notes from the National Uniform Billing Committee (NUBC), there is not a designated timeframe (or limitation) in reporting these new codes, and they define a readmission as ‘‘an intentional readmission after discharge from an acute care hospital that is a scheduled part of a patient’s plan of care.’’ These new discharge status codes are not related in any way to the Hospital Readmissions Reduction Program and will not be taken into account in the readmissions measures for that program.
So, what does this mean to you? You will need to:
- Ensure that your systems have been updated to reflect these changes
- Provide physician education to help ensure that there is clear documentation that they plan on readmitting the patient
- Educate the Health Information Management and Case Management staff
Shown below are the existing ‘‘base’’ discharge status codes and the new codes that will better identify patients who are discharged with a planned readmission.
|
Base code |
New code |
Discharge Status Code Title |
|
01 |
81 |
Discharged to home or self-care with a planned acute care hospital inpatient readmission. |
|
02 |
82 |
Discharged/transferred to a short term general hospital for inpatient care with a planned acute care hospital inpatient readmission. |
|
03 |
83 |
Discharged/transferred to a skilled nursing facility (SNF) with Medicare certification with a planned acute care hospital inpatient readmission. |
|
04 |
84 |
Discharged/transferred to a facility that provides custodial or supportive care with a planned acute care hospital inpatient readmission. |
|
05 |
85 |
Discharged/transferred to a designated cancer center or children’s hospital with a planned acute care hospital inpatient readmission. |
|
06 |
86 |
Discharged/transferred to home under care of organized home health service organization with a planned acute care hospital inpatient readmission. |
|
21 |
87 |
Discharged/transferred to court/law enforcement with a planned acute care hospital inpatient readmission. |
|
43 |
88 |
Discharged/transferred to a federal health care facility with a planned acute care hospital inpatient readmission. |
|
61 |
89 |
Discharged/transferred to a hospital-based Medicare approved swing bed with a planned acute care hospital inpatient readmission. |
|
62 |
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. |
|
63 |
91 |
Discharged/transferred to a Medicare certified long term care hospital (LTCH) with a planned acute care hospital inpatient readmission. |
|
64 |
92 |
Discharged/transferred to a nursing facility certified under Medicaid but not certified under Medicare with a planned acute care hospital inpatient readmission. |
|
65 |
93 |
Discharged/transferred to a psychiatric distinct part unit of a hospital with a planned acute care hospital inpatient readmission. |
|
66 |
94 |
Discharged/transferred to a critical access hospital (CAH) with a planned acute care hospital inpatient readmission. |
|
70 |
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. |
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