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Inpatient FAQ - March 2014

Published on 

Friday, March 7, 2014

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Q:

What is the correct discharge status code assignment for a state-designated vs. a non-state-designated ALF?

BACKGROUND
The Center for Medicare and Medicaid Services MLN Matters Number: SE0801 provides usage information on the correct patient discharge status codes for state-designated and non-state-designated ALFs, with an effective date of March 1, 2007. Since then, the National Uniform Billing Committee (NUBC) has made several revisions to the patient discharge status codes. The differences in the verbiage between CMS and the NUBC has caused a lot of confusion.

A:

Per the NUBC: The most recent (2014) Official UB-04 Data Specifications Manual is correct. “All of the “state designated” language was removed in December, 2008. The bottom line is that discharges to ALFs are always “04”.”

Per CMS:  “The NUBC is responsible for the maintenance and dissemination of guidance for the UB-04 code set.” The CMS has provided a subset of information for Medicare-participating providers. “For greater detail, providers should visit http://www.nubc.org/ in order to purchase a UB-04 manual.”

Please note: The NUBC has the final authority for the definition and instruction for all discharge disposition codes.

Source: MLN Matters Number: SE0801

Source: Direct email response from the NUBC on March 6, 2014

Article Author:

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.