Patient Status Codes window

Enter the code that you want to use for this patient status code type, up to three alphanumeric characters.

Netsmart recommends that the first character of the code correspond to the status code type.

Enter a description for this patient status code, up to 36 alphanumeric characters.

Select Active if this status code is for patients that are admitted to your agency.

Select Prospective if this status code is for patients that are referred to your agency.

Select the status code to associate with this patient status.

Status code types enable the application to determine the action to take with the patient (for example, active, readmitted, discharged).

• A – Initial admission (active and/or prospective).
• D – Death. Only bereavement services are permitted after death.
• F – Final Discharge. First day not on the program; only non-billable and bereavement services are permitted as of the date associated with this code/type.
• R – Return home from a temporary inpatient stay.
• T – Temporary move to hospital/respite. This would be a temporary move to an inpatient facility; services still permitted; patient is still active in the agency.
• X – Readmission. This is for readmission back into the program after final discharge.

Discharge Type

This section is active only for the F (Final Discharge) status code type and allows identifying patient status code for the following discharge types:

• Transfer Out – Select if this patient status is associated with the patients who are transferred out of your agency. This option is also used for PPS/EPS to indicate transfer to another agency, which in turn determines a PEP (Partial Episode Payment) situation.
• Revocation – Select if this patient status is associated with the patients who are revoked.
• No Longer Terminally Ill – Select if this patient status is associated with the patients who are no longer terminally ill.
• Administrative - This selection allows you to perform an administrative discharge for a patient without submitting a discharge Hospice Item Set (HIS) record. This is for circumstances when a patient remains under hospice care with no interruption in service, and completion of a HIS discharge is not required. When you make this selection, you will have the option to select Do not generate HIS. If you select Do not generate HIS, the HIS is not automatically created when the discharge assessment is completed. Subsequently, upon readmission, an admission HIS is not created when the comprehensive assessment is done.

Discharge Status Code

This field is available only for the D (Death) and F (Final Discharge) status code types.

Enter the two-digit discharge code to use with this patient status code, and then select the check boxes next to the needed insurance modes to apply this discharge status code:

• Regular (fee-for-service)
• Benefit (per-diem)
• Hybrid
• Episodic (EPS and PPS)

This code is printed in FL 17 on the UB-04 form and in CL 103 in EMC. However, it is overridden if the print variation for FL 17 is selected or a claim constant for FL 17 is entered.

Select this check box if this patient status is associated with the resource ID of a facility.

A required field called ID (Admission Facility ID) appears in the Admissions and Status.

Select this check box to require completing the Admission/Discharge Time column in Patient>General>Admissions & Status. This check box is available only for the A, D, F, and X patient status codes.

This option allows cutting the time in claims for benefit continuous care services if the patient was discharged or readmitted earlier than rounded in the claim.

This option is also used for identifying DPC visits that occurred after patient's death so that the Post Mortem modifier is added to the HCPCS code for such visits.

This check box is only available for the T (Temporary move to hospital/respite) status code type. Select this check box to indicate that OASIS assessment is not required for a patient. When selected, patients are included in the following reports as follows:

• OASIS Due Alert – Patients are displayed only if they fall within the applicable recertification date range.
• Discharge Summary – Patients with the T (Temporary move to hospital/respite) status code and "No OASIS Required" are not displayed.

Select the special bill type to associate with this patient status. This option overrides the application generation of these bill types. The selection you specify for this status code is the bill type that is printed. The special bill type is an indicator to print on claims 331, 332, 333, 334, 81__, or 82__. The special bill type is usually used when transferring a patient to another hospice.

Select the Suppress NOE check box if the application generates a Notice of Election for patients assigned to this patient status code. This option allows the suppression of the NOE, so if a patient is transferred to another hospice, the hospice benefit is not revoked.

Select this check box if the patient status is associated with the patients who are transferred in from another agency. This information is important for Episodic payers and Hospice.

Select the Field Use Only check box if this patient status is meant for use by field mode users only.

Field use codes enable field device users to complete admission, discharge, transfer, resumption of care, and death information without having to wait for the patient's status to change officially. The application does not generate claims for patients with these statuses. You must later change the status to a standard code to generate claims.

Select the HL7 Use Only check box if this patient status is meant for use with HL7 messaging only.

This field is available for prospective status codes of type A (admission) and active codes of type F (discharge), and T (transfer). It is unavailable for A (admission), D (death) or R (readmission) type status codes. You can specify only one prospective status code of type A for HL7 use and you can specify one active code each of types F and T as HL7 use, for a potential total of four HL7 use codes. If you attempt to save a status code as HL7 use when there is already a code of that type specified for HL7, the application displays an error message. You cannot change an HL7 status code while that code is in use; again, Netsmart Homecare displays an appropriate error message.