UB04 Patient Discharge Status Code 01: Discharged to home or self-care (routine discharge)

Overview

Patient Status Code 01 is a standardized administrative code used on the UB-04 claim form to indicate a routine discharge ^[1]. Specifically, this code signifies that a patient has been discharged to home or self-care [CODE]. Within the UB-04 framework, this status is categorized under Field 17, which tracks the patient's disposition at the end of a medical encounter or inpatient stay [field-17/code-01]. According to the MassHealth Billing Guide, the UB-04 form is required for various facility types, including acute inpatient hospitals, acute outpatient hospitals, and hospital-licensed health centers ^[2]. Code 01 is one of several status indicators—ranging from transfers to other facilities (Codes 02-05) to expiration (Code 20)—used to inform payers of the patient's destination and the conclusion of the current episode of care [PATIENT STATUS CODES].

When to Use

Code 01 must be utilized when a patient’s clinical treatment at the reporting facility has concluded and they are returning to their primary residence without the requirement for immediate, organized follow-up care from a certified health organization [CODE; PATIENT STATUS CODES]. This code is appropriate for "routine discharges" where the patient is capable of self-care or is under the care of family [CODE]. It should be distinguished from Code 06, which is used when a patient is discharged to home under the care of an organized home health service organization [PATIENT STATUS CODES]. Furthermore, Code 01 is only applicable if there is no planned acute care hospital inpatient readmission; if a readmission is planned at the time of discharge to home, Code 81 must be used instead [PATIENT STATUS CODES]. This code is also distinct from situations where a patient leaves against medical advice (Code 07) or remains as an inpatient (Code 30) [PATIENT STATUS CODES].

Step-by-Step Claim Example

To document a routine discharge on a paper UB-04 claim form or via Direct Data Entry (DDE) on the Provider Online Service Center (POSC), follow these steps:

1. Identify the Facility Type: Ensure the provider is an authorized UB-04 submitter, such as an acute inpatient or outpatient hospital ^[2].
2. Determine Patient Disposition: Confirm through medical records that the patient was sent home for self-care and not transferred to a short-term hospital (Code 02), SNF (Code 03), or hospice (Code 50) [PATIENT STATUS CODES].
3. Locate Field 17: On the UB-04 form, find the "Patient Status" field, designated as Form Locator 17 [field-17/code-01].
4. Enter Code 01: Enter the two-digit code "01" in this field to signify a routine discharge to home [CODE].
5. Verify Against Planned Readmissions: Ensure there is no documented plan for an acute care readmission. If such a plan exists, the code must be changed to 81 [PATIENT STATUS CODES].

Common Mistakes & Audit Red Flags

• Misidentifying Home Health Care: A frequent error is using Code 01 when the patient is actually being discharged to the care of a home health service organization. In such instances, Code 06 is required to reflect the anticipation of covered skilled care [PATIENT STATUS CODES].
• Ignoring Planned Readmissions: Using Code 01 when a planned acute care hospital inpatient readmission is scheduled is an audit risk. Effective October 1, 2013, Code 81 must be used for routine discharges with a planned readmission [PATIENT STATUS CODES].
• Confusing Facility Types: Reporting Code 01 for a transfer to a custodial or supportive care facility (Code 04) or a federal health care facility (Code 43) is inaccurate and can lead to claim denials [PATIENT STATUS CODES].
• Incorrect Form Usage: Submitting routine discharge data on forms other than the UB-04 for acute inpatient or outpatient services may result in processing errors ^[2].
• Status Conflicts: Using Code 01 when the patient has actually "left against medical advice" (Code 07) or is "still a patient" (Code 30) creates a discrepancy in the medical record [PATIENT STATUS CODES].

Related Codes/Fields

Code	Meaning	Usage Context
06	Discharged to home under care of home health service	Used when skilled care is anticipated [PATIENT STATUS CODES]
07	Left against medical advice	Used when care is discontinued by the patient [PATIENT STATUS CODES]
30	Still a patient	Used when the patient remains in the facility [PATIENT STATUS CODES]
81	Discharged to home with planned readmission	Used for routine discharge with scheduled return [PATIENT STATUS CODES]
02	Discharged/transferred to short-term hospital	Used for inpatient transfers [PATIENT STATUS CODES]

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References

[1] PATIENT STATUS CODES — https://med.noridianmedicare.com/web/jea/topics/claim-submission/patient-discharge-status-codes

[2] BG-UB-04 (02/21) — https://www.mass.gov/doc/ub-04-billing-guide-0/download