2011 nubc manual discharge status codes 2017

Na current hospice benefit period will be terminated. This article was revised on march 8, 2017, to update information. Dischargedtransferred to a nursing facility certified under medicaid but not certified under medicare. National uniform billing committee nubc uniform bill. Clarification of patient discharge status codes and hospital transfer policies ja0801. The values for discharge status are taken from the national uniform billing committee nubc manual which is used by the billinghim to complete the ub04. Point of origin for admission or visit codes update to the admission codes, discontinued by the national uniform billing committee nubc, will be. Chapter 25 completing and processing the form cms 1450 data set.

The patient discharge status codes listed below is not an allinclusive list. Fl17 patient discharge status 1 an 2 1 fl18 condition code an 2 1 fl19 condition code an 2 1. In 2011 12 chars transitioned to the 837 5010 file format and october 1, 2014 with the united states will move to icd10 codes. Instead, the hospice reports condition code h2 to indicate a cms manual system. This table indicates how to crosswalk the new nubc. See national uniform billing committee for guidelines. May 22, 2015 national uniform billing committee centers for medicare may 25, 2007 from bill type numbers, correction of a typo in condition code 6, and background. Changes to the manual from 2011 through 2017 numerous and significant changes have been made to the ub04 manual from 2011 through 2017. Instructions for completing the ub04 claim form the ub04 claim form is used to submit claims for inpatient and outpatient services by institutional facilities for example, outpatient departments, rural health clinics, chronic dialysis and adult day health care.

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. It is important to select the correct patient discharge status code because it may affect your payment. Hospital discharge discharges for charity or free standard codes and submit them to the tdh hdds staff. Specifications manual for joint commission national quality measures version 2020b1 updated 03302020 sub2,tob2 algorithm updates, pc03 and pc04 retired, accreditation data aggregated ed, imm, sub, tob, vte, hbips, pc, asr, achf, achfop, cstk, pal, stk, stkop, thkrip, thkrop measures.

Mar 16, 2010 year, nubc will draft a recommendation for oct 1, 2011. Jul 6, 2015 implementation of new national uniform billing committee nubc code 53 initial placement of a medical device provided as part of a cms manual system. Beneficiary is deceased report the appropriate nubc discharge status code that. Mar 15, 2017 clarification of patient discharge status codes and hospital transfer policies information on the inpatient transfer policy is located in the clarification of patient discharge status codes. Ub04 form locator appendices in this section, you will find the codes we accept on the ub04 claim form. New condition code for language other than english lote o explore the use of that external code list can\t be used in an x12 standard until new versions. Information on the inpatient transfer policy is located in the medicare claims processing. Some fields have been have been changed or codes have been added or deleted for existing fields. Appropriate patient discharge status for type of bill policy. Application for license to use or distribute ub04 content. Assigning the correct patient discharge status code is just as important as any other. Jan 23, 2008 choosing the patient discharge status code correctly avoids claim errors and. The data elements and codes are developed and maintained by the national uniform billing committee nubc.

Additionally, all codes that have been approved by the nubc and that were not in the claims processing manual have been added to these instructions to comply with. A patient discharge status code is a twodigit code that identifies where the patient is at the conclusion of a health care facility encounter or at the end of a billing cycle the through date of a claim. A ub04 with field descriptions and instructions is included in the link below. Clarification of patient discharge status codes and hospital cms. Per the national uniform billing committee nubc, form locator fl 66. A patient discharge status code is a twodigit code that identifies where the patient is at the conclusion of a health care facility encounter this could be a visit or an actual inpatient stay or at the time end of a billing cycle the through date of a claim. The instructions included in this section are excerpts from medicare instructions rev. Patient discharge status codes 5010 free pdf ebook. Information on the inpatient clarification of patient discharge status codes and cms. Complete list of military separation codes on documents. Military separation codes are contained in your military records and may be annotated on various military separation documents. Report oc 42 and the date of revocation on the final claim. News about new products, improvements, tips and tricks to getting the most out of your findacode subscription. Jan 30, 2017 inpatient hospitals provider type 01 and specialty 010 for larc long paper.

Mar 15, 2017 be utilizing the ub04 manual which is maintained by the national uniform billing. The national uniform billing committee nubc makes their ub04 manual available through their website. This manual, ed by the american hospital association, is the only official source of ub data. Since this is a discharge to outpatient treatment, and it is expected that the patient will go home afterward, use discharge status 01, discharged to home or self care. New patient discharge status codes type of bills tob 32x and 34x.

A valid patient discharge status code is defined by the national uniform billing committee nubc official ub04 data specifications manual 2017 version 2. Manual ub04 fl17 patient status codes dischargedtransferred to a. Nov 26, 2004 condition codes c3 or c7 on original claims and adjustments. Information on the inpatient page 1 of 4 department of health and human. Chapter 25 is being updated to reflect changes approved by nubc. Making copies or utilizing the content of the ub04 manual or ub04 data file, including the codes andor descriptions, for internal purposes. Nubc clarified the following hospice levels of care. A patient discharge status code is a twodigit code entered into form locator fl 17 on the ub04 claim form that identifies the patients status at the conclusion of a health care facility encounter this could be a visit or an actual inpatient stay or at the time end of a billing cycle the through date of a claim found in fl 6 on the ub04. Committee nubc has approved new discharge status codes 8195 that go into effect with october. Jan 05, 2015 nubc meeting march 12, 2011 hilton garden inn chicago mar 1, 2011 line item dates on inpatient claims nubc and dsmo crs 1. Providers using the cd will need to retain all bulletins received throughout the year to use in addition to the cd.

Some fields have been changed, or codes have been added or deleted for existing fields. The national uniform billing committee nubc maintains lists of approved coding for the form. Ja0801 was revised to update the web address on page 3 for accessing the list of designated cancer. Patient discharge status code reporting a discharge occurs when a medicare beneficiary leaves an acute care hospital after receiving acute care treatment. The national uniform billing committee nubc makes their ub04 manual terminology cpt4 codes describe medical procedures and professional. Reimbursement guidelines based on national guidelines for completing and submitting a ub04 or the electronic comparative a provider must assign a patient discharge status code which aligns with the type of bill tob submitted. Patient discharge status codes and hospital transfer policies clarification october 24, 2014 a patient discharge status code is a twodigit code that identifies where the patient is at the conclusion of a health care facility encounter or at the end time of a billing cycle.

National uniform billing committee nubc official ub04 data specifications manual. The following changes have been made by the national uniform billing committee nubc and are outlined below. The nubc data specifications manual provides documentation and further guidance to assistin determining the proper patient discharge status code to use based on the patients status when completing the claim. The national uniform billing committee nubc approved a new patient discharge status code 20 expired, 40 expired at home, 41 expired in a change request 7473 cms. Sep 27, 20 effective october 1, 20, nubc approved sixteen 16 new discharge status codes patient disposition.

Nubc discharge status code that best describes the beneficiarys situation. The manual was created in adobe acrobat portable document format pdf. Clarification of patient discharge status codes and hospital. The purpose of the tob chart in the manual to help guide hipaa users nubc billing alert national uniform billing committee nov 17, 2010 billing alert. If an entered code does not agree with any code on the internal list, it is assumed to be invalid.

Jul 29, 2011 is received with any discharge status code other than 30. Dec 11, 2019 apr 1, 2004 national uniform billing committee nubc and to add all nubc additionally, all codes that have been approved by the nubc and that se1117 cms. Apr 5, 20 66 diagnosis and procedure code qualifier icd version indicator is a. This manual contains the updated specifications for the data elements and codes included on the cms1450 and used.

Enter the four digit code that identifies the specific type status as of the through date. Masshealth billing guide for the ub04 executive office of. Point of origin and discharge status codes for designated disaster alternate care. Apr 30, 2017 clarification of patient discharge status codes and hospital transfer policies. Billing committees nubc official ub04 data specifications manual. The ltchcare data set is the assessment instrument used for all patients receiving inpatient services in a facility certified as a hospital and designated as a ltch under the medicare program. Hmsa has determined that it will use the national uniform billing committee nubc official ub04 data specifications manual as the standard source for codes and code descriptions to be entered in the various form locators fl. Patient discharge status codes and hospital transfer policies. Clarification of patient discharge status codes and cms. Hospital discharge data system user manual august 2018 7 numerous and significant changes have been made to the ub04 manual from 2011 through 2018. Home health medicare billing codes sheet value code fl 3941 61 cbsa code for where hh services were provided. Mar 15, 2017 is located in the medicare claims processing manual 4, chapter clarification on the proper usage of patient discharge status codes, 2017 icd10cm guidelines centers for disease control and.

Clarification of patient discharge status codes and hospital transfer policies. The hospice does not report occurrence code 42 on their claim. This article was revised on march 6, 2014, to remove the reference to clarification of patient discharge status codes and centers for jan 23, 2008 clarification of patient discharge status codes and hospital transfer policies. Because this data element is critical in determining the population for many measures, the abstractor should not assume that the ub04 value is what is reflected in the medical record. On every dialysis claim enter occurrence code 50 and the date of the patients initial dialysis treatment. National uniform billing committee nubc and to ub04 billing guide inpatient hospitals 02017.

Some fields have been changed or codes have been added or deleted for existing fields. Invalid diagnosis or procedure code the medicare code editor checks each diagnosis including the admitting diagnosis and each procedure against a table of valid icd10cm and icd10pcs codes. We have arranged the information this condition code. Ub 04 medicare discharge status code cms 1500 claim form. This manual, ed by the american hospital association, is the only. Ub04 claim form this document explains the ub04 claim form, which is used for submitting claims for reimbursement for specially designated facilities. National uniform billing committee nubc created a new patient discharge code to status code 21 in the list of codes allowed in a same day. The nubc data specifications manual provides documentation and further guidance to assistin. Place 61 in the first value code field locator and the cbsa code in the dollar. Patient assessment information is collected on admission, at discharge and death. The hospitals used incorrect patient discharge status codes on their claims, indicating. Download a sample of the form by visiting the cms forms list web page. No other publication governmental or privatecommercial can be considered authoritative.

Clarification of patient discharge status codes and. A patient discharge status code is a twodigit code that identifies where the patient is at the conclusion of a health care facility encounter or at the end of. Aug 1, 2011 the other diagnosis codes form locators 67a67q language. If a patient is discharged from an acute care hospital to a medicarecertified swing bed in a snf, is the discharge status of 03 correct, or should it be 61. Medicare pays for a discharge or a transfer depends on the status code. This article impacts codes discontinued by the national uniform billing committee nubc will be discontinued for cms manual system.

The chars procedure manual and chars companion guide supplement the national uniform billing committee uniform billing form 2004 nubc ub04 and the asc x12. Committee nubc official ub04 data specifications manual 2008 version 2. Note, if all condition codes are filled, use field 81. For hospitals with an approved swing bed arrangement, use code 61swing bed. In the case of a discharge when the beneficiary moves out of the hospices service area without a transfer, the hospice uses the nubc approved discharge status code that best describes the beneficiarys situation and appends condition code 52. National uniform billing committee nubc update to chapter 25. Status are taken from the national uniform billing committee nubc manual which is. Data element dictionary and ncpdp ncpdp october 2011 data dictionary.

Instead, the hospice reports condition code h2 to indicate a discharge. Manual by permission, copyright 2011, by american hospital association. If the code is invalid or missing, the service will be denied. Patient discharge status faqs new york state department of. The national uniform billing committee nubc ballots and maintains these condition codes as part of the nubc universal billing ub code set, which is an external code set requests for new codes or modification of codes may be submitted through the nubc web site at.

However, in some cases, hmsa varies from nubc directions concerning whether a specific field is required or how the. National uniform billing committee nubc payer only codes general billing requirements, section 190 payer only codes utilized by medicare which clarification of patient discharge status codes and hospital cms. Also, if the patient discharge status code indicates a discharge, one day is subtracted medicare full days loop 2320 mia01 when. Hh 17 stat patient discharge status 2 digit code hospital there are many codes, refer to ub04 manual illinois required for inpatient only 1828 condition codes 2 digit code cmsmedicare manual there are many codes, refer to ub04 manual. Joint commission discharge disposition discharged to home, home health or. Dec 20, 2011 new apg rate codes effective for dates of service dos on xxxx 2012 status code. Numerous and significant changes have been made to the ub04 manual from 2011 through 2017. Nubc official ub04 data specifications manual 2017 version 2. Fl 16 discharge hour 35 fl 17 patient discharge status 36 fl 1828 condition codes 48 fl 29 accident state 61 fl 30 reserved for assignment by the nubc 62 fl 34 occurrence codes and dates 63 fl 3536 occurrence span codes and dates 71 fl 37 reserved for assignment by the nubc 74. This fourdigit alphanumeric code gives three specific pieces of cms manual system cms. These codes are subject to change, and the department of defense will no longer allow the military services to release the meanings of these codes to the general public.

For a current list of patient status codes, please refer to the nubc ub04 manual. You can access the ub04 billing information adopted by the nubc by subscribing to the official ub04 data specifications manual. In the case of a discharge for cause, the hospice uses the nubc approved discharge status code that best describes the beneficiarys situation. Jul 29, 2011 the requirements below are intended to ensure all hospice discharge claims have the required 40, 41, 42, 50 or 51, and occurrence code 42 is not present. Patient discharge status codes are part of the official ub04 data specifications manual and are used nationwide by institutional, private, and public providers, and payers of health care claims. National uniform billing committee nubc uniform bill patient discharge status codes provides a set of patient status codes used for patient billing to be included in discharge status messages. National uniform billing committee centers for medicare may 25, 2007 from bill type numbers, correction of a typo in condition code 6, and background. Apr 1, 2004 cms1450, is being updated to include new condition and value codes approved by the. Claim will terminate the current hospice benefit period as of the oc 42 date. To assist in the proper coding of patient discharge status code, providers may access data elements, codes, and frequently asked questions by referring to the ub04 data specifications manual. To view and utilize the link and search functions of the manual, you will need to have. A patient discharge status code is a twodigit code entered into form locator fl 17 on the ub04 claim form that identifies the patients status at the conclusion of a health care facility encounter this could be a visit or an actual inpatient stay or at the time end of a billing cycle the through date of a.