Section title: Requests for Interpretation
RFI #
2147
PACDR 299 Discharge Date
Description

n the Post Adjudicated Claims Data Reporting: Institutional (837), inpatient encounter discharge date can be submitted in Loop 2300 – HI Occurrence Information with an Occurrence Code = 42 (Date of Discharge). However, there is a note in the UB-04 Data Specifications Manual that says: “Note: Use Occurrence Code 42 to indicate the date of discharge when the “Through” date in Form Locator 06 (Statement Covers Period) is not the actual discharge date and the frequency code in the Form Locator 04 is that of a final bill, i.e., 1, 4, and 7 (when the replacement is for a prior final claim).

We are finding that submitters use the Occurrence segment inconsistently. Some are submitting using the Occurrence Information segment and other are submitting only when the discharge date is different than the Statement To date.

How should we expect to receive inpatient Discharge Dates? What is expected to happen in future versions?

RFI Response

Discharge date is reported in HI01-04 with occurrence code of 42 when statement covers through date is not the date of discharge and claim is the final bill. When the Statement to Date is the Discharge Date, the HI01-04 with occurrence code of 42 will not be present and the discharge date will be found in the 2300 DTP with DTP01 equal to 434. We are not aware of any pending requests to change this approach in future versions.

DOCUMENT ID
005010X299