UB04 Patient Discharge Status Code 42: Expired, place unknown

Overview

Patient discharge status code 42 is defined as “Expired – place unknown” and is used when a patient has died but the exact location of death is not known. ^[1] This code is part of the national set of patient discharge status codes used to report the disposition of a patient after discharge from an inpatient or outpatient setting, including expiration. ^[1] Unlike code 20 (Expired), which is used when death occurs in the facility, or code 41 (Expired in a medical facility), which specifies a healthcare institution, code 42 is reserved for situations where the provider cannot determine where the death occurred. ^[1] The classification is designed to capture mortality data while acknowledging incomplete information about the circumstance of death. ^[1] Code 42 is distinct from code 40 (Expired at home) and code 41, as it explicitly avoids assigning a location. ^[1] Providers should use this code only when a reasonable attempt to ascertain the place of death has been made and the location remains unknown. ^[1]

When to Use

Code 42 is appropriate when a patient has expired but the facility has no reliable information about where the death occurred. ^[1] A common scenario is a patient who leaves the hospital against medical advice, is later found deceased, and the exact location of death (e.g., home, street, or other facility) cannot be confirmed. ^[1] Another example is a patient who is transferred to another healthcare setting but dies en route, and the final place of death is undetermined. ^[1] Code 42 should not be used when the provider knows the death occurred at home (use code 40), in a medical facility (use code 41), or in the current facility (use code 20). ^[1] It also differs from code 41, which is specifically for death in a medical facility such as a hospital, SNF, ICF, or free-standing hospice. ^[1] This code is used primarily by acute inpatient hospitals, critical access hospitals, and other institutional providers that submit UB-04 claims. ^[1] The code is reported in the patient discharge status field of the claim form. ^[1]

Step-by-Step Claim Example

Consider a patient admitted to an acute care hospital for observation. The patient elopes from the facility and is unreachable. Three days later, the patient is found deceased in a wooded area near the hospital. The medical examiner is unable to determine the exact time or location of death relative to the discharge. The hospital must submit a UB-04 claim for the inpatient stay. On the claim, the provider enters patient discharge status code 42 (Expired – place unknown) because the location of death is not known. ^[1] The facility documents in the medical record that the patient left without known destination and was later declared dead, and that no information about the place of death was received. ^[1] The claim is submitted with all other required fields, including patient demographics, dates of service, and revenue codes. ^[1] In this example, code 42 accurately reflects the facility’s knowledge: death occurred, but it cannot assign a location code. ^[1] If the hospital later learns the death took place at home, it should correct the claim using code 40. ^[1]

Common Mistakes & Audit Red Flags

A frequent error is using code 20 (Expired) when the death clearly occurred outside the facility and the location is unknown. ^[1] Code 20 is reserved for death in the current facility, not for post-discharge deaths with an unknown place. ^[1] Another mistake is defaulting to code 41 (Expired in a medical facility) without confirmation, which can lead to inaccurate mortality statistics and potential audit flags. ^[1] Using code 42 as a catch-all for any death that does not occur in the facility is inappropriate; the provider must attempt to determine the location before selecting “unknown.” ^[1] Auditors may flag code 42 if the medical record does not document efforts to determine the place of death. ^[1] Overuse of code 42 compared to codes 40 and 41 may suggest incomplete discharge planning or data entry errors. ^[1] Claims with code 42 are also subject to review for consistency with death certificate information; if the death certificate shows a specific location, the code should be updated. ^[1] Providers should implement a verification process to reduce the use of code 42 to truly unknown situations. ^[1]

Related Codes & Fields

The table below lists related patient discharge status codes for expiration scenarios, as defined in the standard code set. ^[1]

Code	Meaning	Relationship to Code 42
20	Expired	Death occurred in the facility; code 42 is used when location is unknown.
40	Expired at home	Death occurred at home; do not use code 42 if this is known.
41	Expired in a medical facility	Death in a healthcare setting; code 42 is for unknown location.
42	Expired – place unknown	The subject code; used when location cannot be determined.
43	Discharged/transferred to a federal health care facility	Not an expiration code, but may be confused if death occurs at a federal facility; instead use code 41 if death location is known.

These codes are reported in the patient discharge status field of the UB-04 claim form. ^[1] Accurate selection ensures correct reimbursement and reliable mortality reporting. ^[1]

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References

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