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Discharge Status Codes: Out with the Old and In with the New

Published on 

Monday, September 9, 2013

 | Documentation 

Information found in the article has been clarified as of March 22, 2022. Click here to access the updated article.

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Hospitals are facing significant changes with the implementation of the 2014 IPPS Final Rule. Beyond medical necessity guidance, physician certification and recertification for a Part A inpatient admission and the Part A to Part B rebilling, the National Uniform Billing Committee (NUBC) developed and approved new discharge status codes that were finalized for use in the Final Rule.

An interesting twist is that these codes are to be used specifically for DRG 280 (Acute Myocardial Infarction, Discharged Alive with MCC), DRG 281 (Acute Myocardial Infarction, Discharged Alive with CC), DRG 282 (Acute Myocardial Infarction, Discharged Alive without CC/MCC) and DRG 789 (Neonates, Died or Transferred to Another Acute Care Facility).

DRGs 280, 281 and 282:

The finalized rule added one new code for this DRG group.

  • New Code: 69 - Discharged/transferred to a designated disaster alternative care site
  • Purpose: “Is to identify those patients diagnosed with an acute myocardial infarction (AMI) who were discharged/transferred to a designated disaster alternative care site alive.”
  • Final Rule Comments: Most people that commented on this proposal were supportive of adding this new code and anticipate that it will be used infrequently.

The 15 remaining discharge status codes were proposed and finalized to identify planned readmissions after an AMI index admission. The new codes will replace codes already in place. In response to a comment CMS clarified that “at this time, these new discharge status codes are not related in any way to the Hospital Readmission Reduction Program and will not be taken into account in the readmission measures for that program.” The following table is a crosswalk from the current code to the new code. (This table can be found in the Final Rule on pages 50533 – 50534).

Current codeNew codeDischarge status code title
0181Discharged to home or self-care with a planned acute care hospital inpatient readmission.
0282Discharged/transferred to a short term general hospital for inpatient care with a planned acute care hospital inpatient readmission.
0383Discharged/transferred to a skilled nursing facility (SNF) with Medicare certification with a planned acute care hospital inpatient readmission.
0484Discharged/transferred to a facility that provides custodial or supportive care with a planned acute care hospital inpatient readmission.
0585Discharged/transferred to a designated cancer center or children’s hospital with a planned acute care hospital inpatient readmission.
0686Discharged/transferred to home under care of organized home health service organization with a planned acute care hospital inpatient readmission.
2187Discharged/transferred to court/law enforcement with a planned acute care hospital inpatient readmission.
4388Discharged/transferred to a federal health care facility with a planned acute care hospital inpatient readmission.
6189Discharged/transferred to a hospital-based Medicare approved swing bed with a planned acute care hospital inpatient readmission.
6290Discharged/transferred to an inpatient rehabilitation facility (IRF) including rehabilitation distinct part units of a hospital with a planned acute care hospital inpatient readmission.
6391Discharged/transferred to a Medicare certified long term care hospital (LTCH) with a planned acute care hospital inpatient readmission.
6492Discharged/transferred to a nursing facility certified under Medicaid but not certified under Medicare with a planned acute care hospital inpatient readmission.
6593Discharged/transferred to a psychiatric distinct part unit of a hospital with a planned acute care hospital inpatient readmission.
6694Discharged/transferred to a critical access hospital (CAH) with a planned acute care hospital inpatient readmission.
7095Discharged/transferred to another type of health care institution not defined elsewhere in this code list with a planned acute care hospital inpatient readmission.

‍DRG 789:

Three new discharge status codes have been added to this DRG “to identify neonates that are transferred to a designated facility with a planned acute care hospital inpatient readmission.” The new codes can be found on page 50538 of the final rule and include:

New codeDischarge status code title
82Discharged/transferred to a short term general hospital for inpatient care with a planned acute care hospital inpatient readmission.
85Discharged/transferred to a designated cancer center or children’s hospital with a planned acute care hospital inpatient readmission.
94Discharged/transferred to a critical access hospital (CAH) with a planned acute care hospital inpatient readmission.

Suggestions to prepare for the new discharge status codes:

  • Work with your IT Department to ensure that your systems have been updated to reflect these changes,
  • Provide physician education to help ensure that there is clear documentation in the Index admission that he/she is planning on readmitting the patient; and
  • Educate HIM and Case Management staff.
Article Author: Beth Cobb, RN, BSN, ACM, CCDS
Beth Cobb, RN, BSN, ACM, CCDS, is the Manager of Clinical Analytics at Medical Management Plus, Inc. Beth has over twenty-five years of experience in healthcare including eleven years in Case Management at a large multi-facility health system. In her current position, Beth is a principle writer for MMP’s Wednesday@One weekly e-newsletter, an active member of our HIPAA Compliance Committee, MMP’s Education Department Program Director and co-developer of MMP’s proprietary Compliance Protection Assessment Tool.

This material was compiled to share information.  MMP, Inc. is not offering legal advice. Every reasonable effort has been taken to ensure the information is accurate and useful.