UB04 Patient Discharge Status Code 09: Admitted as an inpatient to this hospital

Overview

Patient discharge status code 09 indicates that the patient was admitted as an inpatient to the same hospital that is submitting the UB‑04 claim. ^[1] This code is part of the standard set of discharge status codes used in UB‑04 Field 17 to describe the patient’s disposition at the end of a service or visit. ^[2] Unlike codes such as 01 (discharged to home) or 30 (still a patient), code 09 specifically documents that the patient remained in the facility and was formally admitted for inpatient care. The Massachusetts MassHealth UB‑04 billing guide requires providers to use the correct code sets when completing the claim form, and code 09 is an approved option for these situations. ^[2] Accurate use of code 09 ensures that the claim accurately reflects the patient’s status, which is essential for proper payment and utilization tracking.

When to Use

Code 09 is used when a patient who began a hospital encounter in an outpatient department (e.g., emergency department, observation unit) is subsequently admitted as an inpatient to that same hospital. ^[1] The code applies to the outpatient claim or the claim for the portion of the stay that ended with an inpatient admission, rather than a discharge home or transfer. It does not indicate that the patient was discharged from the hospital; instead, it shows that the patient remained within the same facility as an inpatient. This code should not be used for patients who are discharged to home (code 01), transferred to another facility (codes 02–07, 20–66), or who expire (code 20). ^[1] The MassHealth UB‑04 guide does not provide specific instructions for code 09, but it directs providers to use standard code sets as defined by national sources, such as the National Uniform Billing Committee (NUBC) list, which includes code 09. ^[2] Therefore, code 09 is appropriate for any claim where the patient was admitted as an inpatient to the same hospital after receiving outpatient services.

Step-by-Step Claim Example

Scenario: A patient arrives at the emergency department (ED) of Hospital A at 2:00 PM and is treated for chest pain. After evaluation, the physician orders inpatient admission. The patient is moved to an inpatient bed at 6:00 PM. The hospital will submit a single UB‑04 claim for the entire stay, but the ED services are billed as part of the inpatient claim. However, in some billing scenarios (e.g., separate outpatient ED claim), the outpatient claim must show the patient’s discharge status as “admitted as an inpatient to this hospital.” Using the UB‑04 form, the claim for the outpatient ED visit would be completed as follows:

• Field 17 (Patient Discharge Status): Enter 09 to indicate the patient was admitted as an inpatient to this hospital. ^[1]
• Field 12 (Patient Name): Enter patient’s full name.
• Field 14 (Admission Date): Enter the ED arrival date (e.g., 10/01/2024).
• Field 15 (Admission Hour): Enter the ED arrival hour (e.g., 14:00).
• Field 16 (Type of Admission): Enter the appropriate code for ED visit (e.g., 1 for emergency).
• Field 18–20 (Condition Codes, etc.): Complete as needed per hospital policy.

Finally, submit the UB‑04 claim according to MassHealth’s billing guidelines, using paper only if an electronic waiver has been approved. ^[2] The claim will reflect that the patient was not discharged from the hospital but rather admitted for inpatient care.

Common Mistakes & Audit Red Flags

1. Using code 09 instead of code 30 (Still a patient): If the patient remains in the hospital but has not yet been formally admitted as an inpatient (e.g., in observation status for more than one calendar day), code 30 should be used instead. Code 09 is only for cases where the patient is admitted as an inpatient. ^[1]
2. Using code 09 for transfers: When a patient is discharged and transferred to another inpatient facility (e.g., a skilled nursing facility or another hospital), codes 02–66 (or the 81–94 planned readmission series) must be used, not code 09. ^[1]
3. Omitting code 09 on outpatient claims: Some hospitals forget to enter a discharge status code on outpatient claims when the patient is admitted. This can lead to claim rejection or improper payment. The MassHealth UB‑04 guide emphasizes that all required fields, including Field 17, must be completed correctly. ^[2]
4. Audit red flag: Frequent use of code 09 on claims where the medical record does not document an inpatient admission order may trigger a review for medical necessity and proper admission status. Always ensure the patient’s chart clearly supports the admission decision.

Related Codes/Fields

The table below shows common discharge status codes from the same source as code 09. ^[1]

Code	Meaning
01	Discharged to home or self-care (routine discharge)
02	Discharged/transferred to a short-term general hospital for inpatient care
03	Discharged/transferred to skilled nursing facility (SNF) with Medicare certification
06	Discharged/transferred to home under care of organized home health service organization
07	Left against medical advice or discontinued care
09	Admitted as an inpatient to this hospital
20	Expired
30	Still a patient
43	Discharged/transferred to a federal health care facility
50	Hospice - home
61	Discharged/transferred to a hospital-based Medicare approved swing bed
62	Discharged/transferred to an inpatient rehabilitation facility (IRF)
65	Discharged/transferred to a psychiatric hospital or psychiatric distinct part unit
70	Discharged/transferred to another type of health care institution not defined elsewhere

Field: Patient discharge status code is reported in UB‑04 Field 17. ^[2] Accurate coding of this field is required for compliant claim submission.

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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