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Clarification of Patient Discharge Status Codes and Hospital - cms

Clarification of Patient Discharge Status Codes and Hospital - cms 2025

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The document is a revised MLN Matters® article SE0801, dated January 23, 2008, which clarifies patient discharge status codes and hospital transfer policies. It emphasizes the importance of correctly assigning discharge status codes for Medicare claims to avoid billing errors and ensure timely payments. The article details various discharge status codes, their definitions, and appropriate usage for different healthcare settings, including hospitals, skilled nursing facilities, and hospice care. Additionally, it outlines the implications of these codes under Medicare's inpatient payment systems.

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What are the CMS conditions of participation for discharge planning?

482.43 Condition of participation: Discharge planning. The hospital must have an effective discharge planning process that focuses on the patients goals and treatment preferences and includes the patient and his or her caregivers/support person(s) as active partners in the discharge planning for post-discharge care.

What are discharge status codes?

A patient discharge status code is a two-digit 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).

What is the difference between the hospital discharge codes 99238 and 99239?

Once youve totaled up the time spent on these activities, you can select the appropriate code: If the time spent was 30 minutes or less, 99238 is the correct code. If time spent was over 30 minutes, the correct code would be 99239.

What is the CMS 1599 rule?

CMS final rule 1599-F clarifies that for purposes of payment under Medicare Part A, a Medicare beneficiary is considered an inpatient of a hospital, including a critical access hospital, if formally admitted as an inpatient pursuant to an order for inpatient admission by a physician or other qualified practitioner.

What are the criteria for discharge planning?

IDEAL discharge planning Discuss with the patient and family five key areas to prevent problems at home: Describe what life at home will be like. Review medications . Highlight warning signs and problems . Explain test results . Make followup appointments.

What is CMS discharge status 03?

03 Discharged/transferred to skilled nursing facility (SNF) with Medicare Certification in Anticipation of Covered Skilled Care. Usage Note: Medicareindicates that the patient is discharged/transferred to a Medicare certified nursing facility.

What is the Medicare hospital discharge planning?

Hospital discharge planning is a process that determines the kind of care you need after you leave the hospital. Discharge plans can help prevent future readmissions, and they should make your move from the hospital to your home or another facility as safe as possible.

Clarification of Patient Discharge Status Codes and Hospital - cms 2025

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