Facility Discharge Instruction codes are used in several places in the Facilities section of the application, including:
- Main Table on the Facilities page
- Post Acute Destinations/Discharge Metrics on the Facility Detail Page
- Patients Discharged with Home Health Instructions table (Home Health Only)
- Patients Discharged with SNF Instructions table (SNF Only)
While we label the value a "Discharge Instruction", the value is filled out by the Facility's Medical coder based on a review of the health record. Facilities have different levels of maturity when it comes to coding. Hospitals tend to have a code that more accurately reflects the appropriate destination for the patient. Accuracy within SNFs varies widely.
We determine the instruction for based on the code indicated in Box 17 - Patient Status, from Medicare claim form UB-04 (CMS 1450).
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.
|Post-Acute Destination||Status Code|
Inpatient to Inpatient Rehabilitation Facility (IRF)
|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.)|