UB04 Patient Discharge Status Code 07: Left against medical advice or discontinued care

Overview

Patient Discharge Status Code 07, “Left against medical advice or discontinued care,” is a UB-04 form field code (Form Locator 17) that indicates the patient voluntarily terminated their stay or treatment without the consent of the attending physician. ^[1] This code is used for facilities that submit institutional claims, including acute inpatient hospitals, as required by payers such as MassHealth. ^[2] It distinguishes patients who leave prematurely from those who are discharged home under medical advice or transferred to another care setting. The code also covers cases where a patient discontinues care after admission but before a formal discharge order is written.

When to Use

Code 07 is appropriate when a patient admitted as an inpatient or in observation status chooses to leave the facility before a physician has authorized discharge. ^[1] The code is not used when the patient is discharged home with a planned readmission (those cases use codes 81–87). Nor is it used when the patient dies (code 20) or is transferred to another facility (codes 02–04, etc.).

Step-by-Step Claim Example

Consider a 45‑year‑old patient admitted to an acute inpatient hospital with a diagnosis of pneumonia. On the second day, the patient insists on leaving despite the physician’s recommendation for continued IV antibiotics. The patient signs an AMA form. The hospital completes the UB-04 claim as follows:

• Form Locator 17 (Patient Discharge Status): Enter “07” for “Left against medical advice or discontinued care.” ^[1]
• Form Locator 6 (Patient Name) & 8a (Patient ID): Enter standard patient identification.
• Form Locator 14 (Admission Date): Date of admission.
• Form Locator 15 (Discharge Time): Time the patient left.
• Form Locator 16 (Discharge Date): Date of departure.
• Form Locator 50 (Payer Identification): Primary payer (e.g., Medicare, MassHealth).

The claim is submitted electronically via a clearinghouse (MassHealth requires electronic submission unless a waiver is approved ^[2]).

Common Mistakes & Audit Red Flags

• Using code 07 when the patient only leaves the emergency department without treatment: Code 07 is for admitted patients; a different status code (e.g., 09 for still a patient) may apply to ED visits. ^[1]
• Applying code 07 to patients who are discharged home on medical advice: That scenario requires code 01 (routine discharge). Confusing the two can trigger payment denials or Quality Improvement Organization audits.
• Lacking supporting documentation: Payers require a signed AMA form or clear progress notes detailing the patient’s refusal and the risks explained. Missing documentation is a major red flag in medical review.
• Using code 07 for patients who leave against advice but later return for a planned readmission: In such cases, use the appropriate “with planned readmission” code (81–87) instead. ^[1]
• Coding “07” on outpatient claims: This code is only valid on inpatient UB-04 claims. Outpatient discharge status uses codes 30 (still patient), 20 (expired), etc.
• Reporting code 07 for patients who die: Death is code 20; do not use 07 even if the patient attempted to leave prior to expiration.

Auditors frequently check for documentation timeliness, whether the patient was competent to refuse care, and if the facility made reasonable efforts to retain the patient. Claims lacking these elements may be denied as incomplete or upcoded.

Related Codes/Fields

The following table lists common patient discharge status codes that may be used in Form Locator 17 of the UB-04 claim form, as defined by the source. ^[1]

Code	Description	Notes
01	Discharged to home or self-care (routine discharge)	Most common discharge.
06	Discharged/transferred to home under care of organized home health service organization	Includes anticipated skilled care.
07	Left against medical advice or discontinued care	Focus of this article.
09	Admitted as an inpatient to this hospital	Used for observation-to-inpatient changes.
20	Expired	Patient died while in facility.
30	Still a patient	Not yet discharged (e.g., in outpatient).
50	Hospice – home	Patient discharged to home hospice.
81–94	Codes with "planned acute care hospital inpatient readmission"	Used when a readmission is scheduled.

This field is part of the UB-04 claim form required by MassHealth for acute inpatient and outpatient hospitals. ^[2]

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References

[1] Noridian Patient Status — https://med.noridianmedicare.com/web/jea/topics/claim-submission/patient-discharge-status-codes

[2] MassHealth UB-04 Guide — https://www.mass.gov/doc/ub-04-billing-guide-0/download