Overview
We identify the intention of the discharge planning team for a facility by looking at the status code in box 17 from Medicare claim form UB-04 (CMS 1450).
We use this data to create counts of patients "Coded for..." different types of post-acute care throughout Marketscape. Locations where you will find this metric include:
- Explore page for facilities
- All PAD tables on the Analyze page for facilities.
- Facility Sources table in the Home Health Analyze paqe
The metrics provide an insight into the function and competence of the selected facility's discharge planning team. Facilities have different levels of maturity when it comes to coding, and these metrics will help you to identify facilities with more maturity and those that could use more help.
There are 99 codes available that can be used in this field. We identify the six post-acute care settings using the codes in the table below. ALL other codes are aggregated into the category, "Other." The following table identifies the codes we use for identifying the Post-Acute Care Destinations in the PAD table and for other metrics
| Post-Acute Destination | Status Code |
|
Inpatient to Inpatient Rehabilitation Facility (IRF) |
62 |
| Inpatient to Long Term Care Hospitals (LTCH) | 63 |
| Inpatient to Home Health Agency (HHA) | 06 |
| Inpatient to Hospice (HOS) | 40, 50,51 |
| Inpatient to Skilled Nursing Facility (SNF) | 03 |
| Inpatient to Home or Self Care (No PAC) | blank, 0, 00, 01 (01 is the suggested code.) |
| Other | All others |
Based on the claims, there is no way to know whether a patient received any kind of guidance about post-acute care at the time of discharge, nor can we determine the nature of any instructions provided. Discharge coding is only about the status code on the form.
