1

Routine discharge

2

Discharged to another short-term general hospital

3

Discharged to SNF

4

Discharged to intermediate care facility (ICF)

5

Discharged to another type of institution

6

Discharged to care of home health service organization

7

Left against medical advice

8

Discharged or transferred to home under care of a Home IV provider

9

Admitted as an inpatient to this hospital (only for use on Medicare outpatient hospital claims)

20

Expired or did not recover

30

Still client (To be used only when the client has been in the facility for 30 consecutive days and payment is based on diagnosis-related group [DRG])

40

Expired at home (hospice use only)

41

Expired in a medical facility (hospice use only)

42

Expired - place unknown (hospice use only)

43

Discharged or transferred to a federal hospital (such as a Veterans Administration [VA] hospital)

50

Hospice-Home

51

Hospice-Medical facility

61

Discharged or transferred within this institution to a hospital-based Medicare approved swing bed

62

Discharged or 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)

64

Discharged or transferred to a nursing facility certified under Medicaid, but not certified under Medicare

65

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

66

Discharged or transferred to a critical access hospital (CAH)

71

Discharged to another institution of outpatient (OP) services

72

Discharged to another institution

01

Auto accident/auto liability insurance involved

Enter the date of auto accident. Use this code to report an auto accident that involves auto liability insurance requiring proof of fault.

02

Auto or other accident/no-fault involved

Enter the date of an accident, including auto or other, where no-fault coverage allows insurance immediate claim settlement without proof of fault. Use this code in conjunction with occurrence codes 24, 50, or 51 to document coordination of benefits with the no-fault insurer.

03

Accident/Tort liability

Enter the date of an accident (excluding automobile) resulting from a third party's action. This incident may involve a civil court action in an attempt to require payment by the third party, other than no-fault liability.

04

Accident/employment-related

Enter the date of an accident that allegedly relates to the client's employment and involves compensation or employer liability. Use this code in conjunction with occurrence codes 24, 50, or 51 to document coordination of benefits with workers compensation insurance or an employer. Only services that are not covered by workers compensation may be considered for payment by the CSHCN Services Program.

05

Other accident

Enter the date of an accident not described by the above codes. Use this code to report that no other casualty-related payers have been determined.

06

Crime victim

Enter the date on which a medical condition resulted from alleged criminal action.

11

Onset of symptoms

Indicate the date the client first became aware of the symptoms or illness being treated.

16

Date of last therapy

Indicate the last day of therapy services for OT, PT, or speech therapy (ST).

17

Date outpatient OT plan established or last reviewed

Indicate the date a plan was established or last reviewed for occupation therapy.

24

Date other insurance denied

Enter the date of denial of coverage by a TPR.

25

Date benefits terminated by primary payer

Enter the last date for which benefits are claimed.

27

Date home health plan of treatment was established

Enter the date the current plan of treatment was established.

29

Date outpatient PT plan established or last reviewed

Indicate the date a plan of treatment was established or last reviewed for PT.

30

Date outpatient speech pathology plan established or last reviewed

Indicate the date a plan of treatment was established or last reviewed for speech pathology.

35

Date treatment started for PT

Indicate the date services were initiated for PT.

44

Date treatment started for OT

Indicate the date services were initiated for OT.

45

Date treatment started for speech-language pathology (SLP)

Indicate the date services were initiated for SLP.

50

Date other insurance paid

Indicate the date other insurance paid the claim.

51

Date claim filed with other insurance

Indicate the date the claim was filed with other insurance.

52

Date renal dialysis treatment started

Indicate the date services were initiated for renal dialysis.