Practice Management Alert

Question: I heard we would no longer be using patient status code 01 or 05 to bill for patient discharges to a critical access hospital (CAH). What should we use instead?


Arizona Subscriber  
Answer: There is now a new billing code to define a patient's discharge or transfer to a CAH - patient status code 66 (Discharges/transfers to a Critical Access Hospital). You should use this code for discharges or "transfer to" dates on or after Jan. 1, 2006. Explanation: A May 13 CMS transmittal stated that "previously, there was no patient status code to define discharges or transfers to a CAH." Providers instead had to use status code 01 (Discharged to home or self-care [routine discharge]) or 05 (Discharged/transferred to another type of institution for inpatient care or referred for outpatient services to another institution) because there  wasn't another available option. Important: You must use patient status code 66 to avoid payment snags - even though CMS hasn't issued any payment implications for transfers or postacute transfers. To read the CMS transmittal, go to www.cms.hhs.gov/manuals/pm_trans/R156OTN.pdf.