Discharge status codes may look like just two digits, but they play a major role in getting claims paid correctly. These codes appear on institutional claims—especially the UB-04 form—and indicate where a patient went after discharge. In 2025, payers like Medicare, Medicaid, and commercial insurers continue to focus on these codes for compliance and reimbursement.
What Are Discharge Status Codes?
Discharge status codes—also called patient status codes—identify a patient’s disposition at discharge. You’ll enter these two-digit codes in Field Locator 17 (FL17) of the UB-04. For example:
- 01 – Discharged to home
- 03 – Transferred to a skilled nursing facility (SNF)
- 06 – Discharged with home health services
- 20 – Patient expired
- 30 – Still a patient (used for interim billing)
These codes are defined by the National Uniform Billing Committee (NUBC) and used by hospitals, SNFs, and other institutional providers.
Why Accurate Discharge Status Coding Matters
Getting the status code right is more than just compliance—it affects revenue. Here’s why:
- Payment Accuracy: Medicare adjusts DRG payments based on discharge status. An error could cause underpayments or costly recoupments.
- Downstream Claim Impact: If your discharge status doesn’t align with the next facility’s claim, their payment could be delayed or denied.
- Audit Risk: Contractors audit discharge status codes. Mistakes—even without payment errors—can trigger reviews.
2025 Updates and Payer Focus
No new discharge codes were introduced for 2025. However, payer scrutiny remains high. Medicare, Medicaid, and insurers like UnitedHealthcare continue to enforce alignment between discharge status and claim type.
For instance, status code 30 (still a patient) should only be used on interim claims—not final bills. Medicare’s IPPS transfer policy also relies on these codes to determine if a reduced per diem payment applies.
Best Practices for Accurate Coding
- Verify the Discharge: Always confirm where the patient actually went—especially if plans changed after discharge.
- Review Documentation: Ensure notes from discharge planners, case managers, or providers support the code used.
- Avoid Code 30 Errors: Don’t leave “still a patient” as a default on final bills—it’s a common mistake that causes rejections.
- Train Billing Staff: Create a quick-reference guide with definitions and payer-specific notes.
Discharge Status Examples by Setting
Hospital Inpatient Billing
- Discharge to SNF → Use 03
- Discharge to home health → Use 06
- Planned readmission → Use 81–95 series codes
Skilled Nursing Facility (SNF) Billing
- Resident still in facility at month-end → Use 30
- Resident discharged to acute care hospital → Use 02
Common Mistakes and How to Avoid Them
- Mismatch between plan and reality: Patient was planned for SNF but discharged home? Code must reflect what actually occurred.
- Confusing similar codes: For example, 03 (SNF) vs 62 (rehab hospital). Use documentation to clarify.
- Missing death/hospice codes: Be sure to use 20, 40–42, or 50/51 as appropriate—and report date of death when required.
Frequently Asked Questions
Do professional claims (CMS-1500) require discharge codes?
No. Discharge status codes are only required on institutional claims (UB-04), not professional claims.
Can the discharge code delay another provider’s payment?
Yes. If your code doesn’t match the receiving facility’s expected data, their claim could deny. Coordination is key.
Should I ever use code 30 on a final claim?
No. Code 30 (still a patient) is for interim bills only. Final claims must reflect the actual discharge status.
Conclusion
Discharge status codes affect billing accuracy, claim acceptance, and reimbursement. In 2025, they remain under payer scrutiny. Review documentation, understand code definitions, and train your team to avoid costly mistakes. For more institutional billing help, explore our guides on UB-04 field usage and ICD-10 coding tips.