[[Manual/Releases.ReleaseRecord0025][]] Note for "Point of Origin for Admission or Visit"

• *Topic Version for Release 20
• Topic has changed since last release: Compare versions

Rationale

Data element is now a measure specific data element. To align with NUBC changes.

Description

Under collected for change:
PC

to:

PC-04, PC-05

Change Allowable Values:

1 Non-Health Care Facility Point of Origin
The patient was admitted to this facility upon order of a physician.
Usage Note: Includes patients coming from home, a physician’s office, or workplace

to:

1 Non-Health Care Facility Point of Origin
Inpatient:The patient was admitted to this facility.

Outpatient:The patient presented to this facility for outpatient services.
Usage Note: Includes patients coming from home or workplace

Change:

2 Clinic
The patient was admitted to this facility as a transfer from a freestanding or non-freestanding clinic.

to:

2 Clinic or Physician
Inpatient:The patient was admitted to this facility.

Outpatient:The patient presented to this facility for outpatient services.

Under the Notes for Abstraction change:

• The intent of this data element is to focus on patients’ place or point of origin rather than the source of a physician order or referral.
• The point of origin is the direct source for the particular facility.

Example 1: A SNF patient has chest pain is taken to the emergency department of Hospital A where it is determined that she is suffering an acute myocardial infarction. The patient is then transferred to Hospital B for admission as an inpatient. The Point of Origin for Hospital A would be 5 – Transfer from a Skilled Nursing Facility (SNF) or Intermediate Care Facility (ICF); the point of origin code for Hospital B would be 4 – Transfer from a Hospital.

Usage Notes/Cases:

I. Transfers – From an Another Facility Overall Scenario While at another acute care hospital/facility, the patient is seen by the emergency room physicians. The patient is then transferred to our facility through the emergency room.

• The Point of Origin code would be Code 4 – Transfer from a Hospital (Different Facility) due to the patient being seen at the other acute care facility’s emergency room.
• If the decision to admit was not made by the other facility’s emergency room personnel and instead was made by our facilities emergency doctor, the Point of Origin code would still be 4. Even though the decision to admit was not made by the other facility, the patient was still seen by the other facility’s emergency room personnel and a decision to transfer was made by them.
• The patient is seen by the other facility’s emergency room physician; the patient arrives at our emergency room, but receives no additional emergency room care at our facility. Instead, the patient is transferred immediately to the Heart Catheterization Department of our facility the Point of Origin code would still be 4. Since the patient is seen by a different hospital’s emergency room personnel, the decision to transfer the patient is first made by the other facility. The arrival of the patient at the receiving hospital’s emergency room and subsequent transfer to the Heart Catheterization Department is secondary to the transfer from the previous facility transfer.

II. Transfers – Skilled Nursing Facility Overall Scenario A resident from a skilled nursing facility is taken to an acute care hospital for medical care.

• The Point of Origin code would be Code 5 – Transfer from a Skilled Nursing Facility.
• The patient’s family stopped by to pick-up the patient for a routine doctor’s office visit (regularly scheduled); but while at the doctor’s office the doctor sends the patient to the emergency room from the acute care hospital. The Point of Origin code would be a 5 as the original Point of Origin is the skilled nursing facility. The subsequent visit to the doctor’s office (or even the emergency room of the hospital) is secondary to the events that took place earlier that day.

III. Transfer by Law Enforcement or Court Overall Scenario A patient arrives at the health care facility accompanied by police.

• The Point of Origin code would be Code 8 – Court/Law Enforcement as the patient is under the supervision of law enforcement.

to:

• The intent of this data element is to focus on patients’ place or point of origin rather than the source of a physician order or referral.
• The point of origin is the direct source for the particular facility.
• Code of Structure for Newborn should be selected when the hospital issues the birth certificate and Admission Type is 4.

Example 1: A newborn is born in an ambulance on the way to the hospital. The patient is then transported to the hospital's nursery for admission as an inpatient. The hospital issues the birth certificate. The Point of Origin for the patient would be assigned under the Code Structure for Newborn as 6 – Born Outside this Hospital.

Usage Notes/Cases:

I. Transfers – From an Another Facility Overall Scenario While at another acute care hospital/facility, the patient is seen by the emergency room physicians. The patient is then transferred to our facility through the emergency room.

• The Point of Origin code would be Code 4 – Transfer from a Hospital (Different Facility) due to the patient being seen at the other acute care facility’s emergency room.
• If the decision to admit was not made by the other facility’s emergency room personnel and instead was made by our facilities emergency doctor, the Point of Origin code would still be 4. Even though the decision to admit was not made by the other facility, the patient was still seen by the other facility’s emergency room personnel and a decision to transfer was made by them.
• The patient is seen by the other facility’s emergency room physician; the patient arrives at our emergency room, but receives no additional emergency room care at our facility. Instead, the patient is transferred immediately to the Neonatal Intensive Care Unit of our facility the Point of Origin code would still be 4. Since the patient is seen by a different hospital’s emergency room personnel, the decision to transfer the patient is first made by the other facility. The arrival of the patient at the receiving hospital’s emergency room and subsequent transfer to the Neonatal Intensive Care Unit is secondary to the transfer from the previous facility transfer.

Overall Scenario While at another acute care hospital/facility, the patient is born. The patient is then transferred to our facility as a direct admit to the Neonatal Intensive Care Unit.

• The Point of Origin code would be Code 4 – Transfer from a Hospital (Different Facility) due to the patient being seen at the other acute care facility’s nursery.