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Release Notes:
Data Element
Version 2012B

Data Element Name: Point of Origin for Admission or Visit
Collected For: PBM-06, PC-04, PC-05,
Definition:A code indicating the point of patient origin for this admission.
Suggested Data Collection Question:What was the point of origin for this admission?
Format:
Length:1
Type:Alphanumeric
Occurs:1
Allowable Values:

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

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

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

3 Reserved for assignment by the NUBC
(Discontinued effective 10/1/2007.)

4 Transfer From a Hospital (Different Facility)
The patient was admitted to this facility as a hospital transfer from an acute care facility where he or she was an inpatient or outpatient.
Usage Note: Excludes Transfers from Hospital Inpatient in the Same Facility (See Code D).

5 Transfer from a Skilled Nursing Facility (SNF) or Intermediate Care Facility (ICF)
The patient was admitted to this facility as a transfer from a SNF or ICF where he or she was a resident.

6 Transfer from another Health Care Facility
The patient was admitted to this facility as a transfer from another type of health care facility not defined elsewhere in this code list.

7 Reserved for assignment by the NUBC
(Discontinued effective 10/1/2010.)

8 Court/Law Enforcement
The patient was admitted to this facility upon the direction of court of law, or upon the request of a law enforcement agency.
Usage Note: Includes transfers from incarceration facilities.

9 Information not Available
The means by which the patient was admitted to this hospital is unknown.

A Reserved for assignment by the NUBC (Discontinued effective 10/1/2007.)

D Transfer from One Distinct Unit of the Hospital to another Distinct Unit of the Same Hospital Resulting in a Separate Claim to the Payer
The patient was admitted to this facility as a transfer from hospital inpatient within this hospital resulting in a separate claim to the payer.
Usage Note: For purposes of this code, “Distinct Unit” is defined as a unique unit or level of care at the hospital requiring the issuance of a separate claim to the payer. Examples could be include observation services, psychiatric units, rehabilitation units, a unit in a critical access hospital, or a swing bed located in an acute hospital.

E Transfer from Ambulatory Surgery Center
The patient was admitted to this facility as a transfer from an ambulatory surgery center.

F Transfer from Hospice and is Under a Hospice Plan of Care or Enrolled in a Hospice Program
The patient was admitted to this facility as a transfer from hospice.

Code of Structure for Newborn (Used For PC-04 and PC-05 Only)
1-4 Reserved for assignment by the NUBC.
(Discontinued effective 10/1/2007)


5 Born Inside the Hospital
A baby born inside this Hospital

6 Born Outside this Hospital
A baby born outside this Hospital

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

Notes for Abstraction:
  • 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.

Suggested Data Sources:

  • Emergency department record
  • History and physical
  • Face sheet
  • Progress notes
  • Nursing admission notes
  • UB-04, Field Location 15
Additional Notes: Reprinted from National Uniform Billing Committee Official UB-04 Data Specifications Manual by permission, Copyright 2011, by American Hospital Association.
Guidelines for Abstraction:
Inclusion Exclusion
None None

Point of Origin for Admission or Visit
Specifications Manual for Joint Commission National Quality Measures (v2012B)
Discharges 07-01-12 (3Q12) through 12-31-12 (4Q12)
Questions? Ask Question to Joint Commission staff Copyright © 2012 by The Joint Commission.