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Question: Discharge Code and Transfers of Patients

Hello, I am a vendor, seeking guidance on behalf of a member. My member is worried that she has some cases qualifying for the STK_OP-1 measure due to discharge code. Some cases may be transferred to another facility due to insurance reasons and not because care needed to be transferred to "higher level of care". Coding has used a discharge code value 4a, but again, patient is only being transferred out because of insurance reasons. Since there is no question asking why patient was transferred to next level of care, would it be acceptable for member to change discharge code to "8" in order to exclude these types of patients that need to be transferred out due to insurance reasons? Please advise.

Answer:

Joanne, It is not acceptable to change the Discharge Code. Regardless of the reason for transfer, we want to know how long stroke patients are being kept in the ED prior to transfer to another hospital. If the patient requests the transfer or is transferred for insurance purposes, we expect that the transfer will be timely. Thank you for your inquiry.

Question Details
Focus area(s): Chart Abstracted Measure Specifications – Clinical
Related documents: STK-OP,
Manual: Current Manual (current data collection period; prior to data transmission)
File:

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