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Release Notes:
Data Element
Version 2010B

Data Element Name: Discharge Status
Collected For: All Records , (used in algorithm for AMI-1, AMI-2, AMI-3, AMI-4, AMI-5, AMI-6, AMI-9, AMI-T1a and AMI-T2 [CMS Optional Test Measures], CAC-3 [Joint Commission Test Measure], All HF Measures, All PN Measures, PR-2)
Definition:The place or setting to which the patient was discharged.
Suggested Data Collection Question:What was the patientís discharge disposition?
Format:
Length:2
Type:Alphanumeric
Occurs:1
Allowable Values:

01    Discharged to home care or self care (routine discharge)
Usage Note: Includes discharge to home; jail or law enforcement; home on oxygen if DMS only; any other DMS only; group home, foster care, and other residential care arrangements; outpatient programs, such as partial hospitalization or outpatient chemical dependency programs; assisted living facilities that are not state-designated.

02    Discharged/transferred to a short term general hospital for inpatient care

03    Discharged/transferred to skilled nursing facility (SNF) with Medicare certification in anticipation of skilled care
Usage Note: Medicare-indicates that the patient is discharged/transferred to a Medicare certified nursing facility. For hospitals with an approved swing bed arrangement, use Code 61-Swing Bed. For reporting other discharges/transfers to nursing facilities, see 04 and 64.

04    Discharged/transferred to an intermediate care facility (ICF)
Usage Note: Typically defined at the state level for specifically designated intermediate care facilities. Also used to designate patients that are discharged/transferred to a nursing facility with neither Medicare nor Medicaid certification and for discharges/transfers to state designated Assisted Living Facilities.

05    Discharged/transferred to a designated cancer center or childrenís hospital
Usage Note: Transfers to non-designated cancer hospitals should use Code 02. A list of (National Cancer Institute) Designated Cancer Centes can be found at http://www3.cancer.gov/cancercenters/centerslist.html

06    Discharged/transferred to home under care of organized home health service organization in anticipation of covered skilled care
Usage Note: Report this code when the patient is discharged/transferred to home with a written plan of care (tailored to the patientís medical needs) for home care services.

07    Left against medical advice or discontinued care

20    Expired

43    Discharged/transferred to a federal health care facility
Usage Note: Discharges and transfers to a government operated health care facility such as a Department of Defense hospital, a Veteranís Administration hospital or a Veteranís Administration nursing facility. To be used whenever the destination at discharge is a federal health care facility, whether the patient resides there or not.

50    Hospice - home

51    Hospice - medical facility (certified) providing hospice level of care

61    Discharged/transferred to hospital-based Medicare approved swing bed
Usage Note: Medicare-used for reporting patients discharged/ transferred to a SNF level of care within the hospital's approved swing bed arrangement.

62    Discharged/transferred to an inpatient rehabilitation facility (IRF) including rehabilitation distinct part units of a hospital

63    Discharged/transferred to a Medicare certified long term care hospital (LTCH)
Usage Note: For hospitals that meet the Medicare criteria for LTCH certification.

64    Discharged/transferred to a nursing facility certified under Medicaid but not certified under Medicare

65    Discharged/transferred to a psychiatric hospital or psychiatric distinct part unit of a hospital

66    Discharged/transferred to a Critical Access Hospital (CAH)

70    Discharged/transferred to another type of health care institution not defined elsewhere in this code list (See Code 05)

THE JOINT COMMISSION NOTE:
If state assigned codes are used, it is the measurement systemís responsibility to crosswalk the code to one of the allowable values listed above for the purposes of ORYXģ.

Note:
CMS and The Joint Commission are aware that there are additional UB-04 allowable values for this data element; however, they are not used for the national quality measures set at this time.

Notes for Abstraction:
  • The values for Discharge Status are taken from the National Uniform Billing Committee (NUBC) manual which is used by the billing/HIM to complete the UB-04.
  • Because this data element is critical in determining the population for many measures, the abstractor should NOT assume that the UB-04 value is what is reflected in the medical record. For abstraction purposes, it is important that the medical record reflect the appropriate discharge status. If the abstractor determines through chart review that the claim information discharge status is not what is reflected in the medical record, she/he should correct and override the downloaded value.
  • It would be appropriate to work with your billing office to develop processes that can be incorporated to improve medical record documentation to support the appropriate discharge status and to ensure consistency between the claim information discharge status and the medical record.
Suggested Data Sources:
  • Face sheet
  • Progress notes
  • Physician orders
  • Discharge summary
  • Discharge instruction sheet
  • Nursing discharge notes
  • Social service notes
  • Transfer record
  • UB-04, Field Location: 17
Additional Notes:
Guidelines for Abstraction:
Inclusion Exclusion
  • None

Discharge Status
Specifications Manual for Joint Commission National Quality Core Measures (2010B)
Discharges 10-01-10 (4Q10) through 03-31-11 (1Q11)