UB04 Patient Discharge Status Code 21: Discharged/transferred to court/law enforcement

Overview

Discharge status code 21, defined as “Discharged/transferred to court/law enforcement,” is used on the UB-04 claim form in Field 17 (Patient Discharge Status) to indicate that the patient left the facility into the custody of court officers or law enforcement personnel. ^[1] This code is part of the standard set of patient discharge status codes maintained by the National Uniform Billing Committee (NUBC) and adopted by Medicare and many Medicaid programs. ^[1] The UB-04 claim form itself is required for paper submissions by acute inpatient and acute outpatient hospitals, including hospital-licensed health centers, according to MassHealth billing instructions. ^[2]

When to Use

Use code 21 only when the patient’s destination after discharge is a court, jail, police station, or other law enforcement custody location. ^[1] (The MassHealth guide references the UB-04 form instructions but does not specifically define this code; the definition derives from the NUBC standard listed by Noridian.)

Step-by-Step Claim Example

Consider a 45‑year‑old male admitted to the hospital for chest pain. During the second day of his stay, an outstanding arrest warrant is served, and the patient is discharged into the custody of local police. The claim is submitted on a UB-04 form as follows:

• Field 17 (Patient Discharge Status): Enter 21 (“Discharged/transferred to court/law enforcement”). ^[1]
• Field 12 (Patient Name): John Doe
• Field 13 (Patient Address): 123 Main St, Anytown, ST 12345
• Field 14 (Birth Date): 01/01/1979
• Field 15 (Sex): M
• Field 6 (Patient Control Number): 123456
• Field 8 (Patient ID): 987654
• Field 16 (Admission Date): 01/10/2025
• Field 18 (Condition Codes): (e.g., code A3 for inmate status if applicable)
• Field 42–44 (Revenue Codes and Charges): Revenue code 0140 (medical/surgical general) with associated charges.
• Field 66 (Diagnosis): I20.9 (Angina pectoris, unspecified).
• Field 77 (Attending Provider): Dr. Jane Smith, NPI 1234567890.
• The discharge time and date are recorded per standard billing requirements. ^[2] (General UB-04 completion instructions apply.)

The claim is then submitted electronically or via approved paper waiver with code 21 clearly indicating the non‑healthcare destination.

Common Mistakes & Audit Red Flags

• Using code 21 for court-ordered psychiatric transfers: If a patient is admitted to a psychiatric hospital or unit by court order, use code 65 or 93, not 21. Auditors will flag mismatches between discharge status and the receiving facility type. ^[1]
• Confusing code 21 with “left against medical advice” (code 07): If a patient leaves to avoid arrest without law enforcement involvement, code 07 is correct; 21 implies active transfer to custody. ^[1]
• Omitting the planned readmission variant: Effective October 1, 2013, code 87 exists for “discharge/transfer to court/law enforcement with a planned acute care hospital inpatient readmission.” If the patient is expected to return for a scheduled readmission, code 87 must be used instead of 21. ^[1]
• Inconsistent documentation: Medical records should clearly note the involvement of law enforcement and the exact destination (e.g., county jail, police station). Auditors often cross-check discharge status against nursing notes and discharge summaries. ^[2] (General audit guidelines from MassHealth.)
• Using code 21 for transfers to a correctional healthcare facility: If the patient is moved to a prison hospital or jail infirmary that functions as an acute care hospital, code 02 (transfer to short‑term general hospital) is more accurate. ^[1]

Related Codes/Fields

Code	Meaning	Source
01	Discharged to home or self-care	[1]
02	Discharged/transferred to a short‑term general hospital for inpatient care	[1]
03	Discharged/transferred to SNF (Medicare certified)	[1]
04	Discharged/transferred to custodial/supportive care facility	[1]
05	Discharged/transferred to designated cancer center or children’s hospital	[1]
06	Discharged to home with home health services	[1]
07	Left against medical advice	[1]
20	Expired	[1]
21	Discharged/transferred to court/law enforcement	[1]
30	Still a patient	[1]
43	Discharged/transferred to a federal health care facility	[1]
65	Discharged/transferred to psychiatric hospital or psychiatric distinct part unit	[1]
87	Discharged/transferred to court/law enforcement with planned acute readmission	[1]
93	Discharged/transferred to psychiatric hospital/unit with planned acute readmission	[1]

All codes listed above are sourced from the Noridian patient discharge status code list published for Medicare claims. ^[1] The UB-04 field 17 is the standard location for these codes, as referenced in the MassHealth UB-04 billing guide. ^[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