Changes to Point of Origin Codes

on Wednesday, 24 March 2010. All News Items

CMS rescinded Transmittal 1917 and replaced it with Transmittal 1929 on March 9, 2010.  The new transmittal changes the title of Code 2 to “Clinic or Physician’s Office.”  All other information described below remains the same.

In accordance with changes made by the National Uniform Billing Committee (NUBC), the following Point of Origin for Admission or Visit (formerly Source of Admission) codes will be discontinued for use by Medicare Systems effective July 1, 2010.

  • 7 – Emergency Room (ER) – Inpatient: The patient was admitted to this facility after receiving services in this facility’s emergency room department. 
  • B – Transfer from Another Home Health Agency
  • C – Readmission to Same Home Health Agency
     * Codes B and C apply to home health agencies and these changes were addressed  in CMS Transmittal 1904.

Changes are also being made to the definition language of Point of Origin codes “1” and “2” although the processing of these codes is not being changed.  See the chart below for the old and new definitions and examples.

1

Non-Health Care Facility Point of Origin (Physician Referral)  Effective July 1, 2010: Non-Health Care Facility Point of Origin

Inpatient: The patient was admitted to this facility upon an order of a physician.  Effective July 1, 2010: Inpatient: The patient was admitted to this facility
Usage note: Includes patients coming from home, a physician's office, or workplace.  Effective July 1, 2010: Examples: Includes patients coming from home or workplace. Outpatient: The patient present to this facility with an order from a physician for services or seeks scheduled services for which an order is not required (e.g. mammography).  Includes non-emergent self referrals.  Effective July 1, 2010: Outpatient: The patient presented to this facility for outpatient services.
2 Clinic or Physician's Office Inpatient: The patient was admitted to this facility as a transfer from a freestanding or non-freestanding clinic.  Effective July 1, 2010: Inpatient: The patient was admitted to this facility.
Outpatient: The patient was referred to this facility for outpatient or referenced diagnostic services.  Effective July 1, 2010: Outpatient: The patient presented to this facility for outpatient services.

For more information, please refer to CMS Transmittal 1917 or the MLN Mattes Article MM6801.

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