Patient Discharge Status Codes Matter

Published 06/07/2024

The Comprehensive Error Rate Testing (CERT) contractor continues to identify claim errors related to patient discharge status codes billed at the end of a health care facility encounter. Patient discharge status codes identify where a patient is being discharged to at the end of their facility stay or transferred to such as an acute/post-acute facility. The discharging facility should ensure that documentation in the patient’s medical record supports the correct billed discharge status code. The code reported on the claim must match the patient’s location or the type of care received after discharge or transfer according to the documentation submitted for review and/or the Common Working File (CWF). Providers are responsible for coding the discharge bill based on the discharge plan for the patient and are encouraged to follow-up with the patient after discharge and prior to submitting the claim to Medicare to ensure the patient went to the planned facility that was recorded in the medical record.

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