UB04 Patient Discharge Status Code 50: Discharged/transferred to Hospice - home

Overview

Patient Discharge Status Code 50 is used on the UB-04 claim form (Field 17) to indicate that the patient was discharged or transferred to hospice care provided in the patient’s home. ^[1] lists this code as “Hospice – home.” The UB-04 claim form is the standard paper claim used by institutional providers such as acute inpatient and outpatient hospitals. ^[2] provides detailed instructions for completing the form, including the use of standardized code sets. Code 50 is one of many patient discharge status codes that describe the patient’s disposition after an inpatient stay. Accurate reporting of this code is essential for proper claim processing, reimbursement, and quality measurement. The code signifies that the patient is leaving the hospital to receive hospice services in a home setting, typically under a hospice plan of care. This differs from code 51, which indicates discharge to a hospice medical facility. ^[1]

When to Use

Code 50 should be used when a patient is discharged from an inpatient hospital stay and is transferred to a hospice program that provides care in the patient’s home. ^[1] defines code 50 as “Hospice – home.” This applies whether the hospice care is provided by a Medicare-certified hospice or another recognized hospice organization, as long as the care is delivered in a private residence. The code is distinct from code 51 (“Hospice – medical facility (certified) providing hospice level of care”), which is used when the patient is discharged to a hospice inpatient facility. ^[1] Providers should also differentiate code 50 from code 01 (“Discharged to home or self-care”), which implies no formal home health or hospice services, and from code 06 (“Discharged/transferred to home under care of organized home health service organization”), which involves skilled home health care rather than hospice. ^[1] The decision to use code 50 must be based on documented evidence that the patient has elected the Medicare hospice benefit (or equivalent) and that the hospice agency will provide routine home care. The code is applicable for all payer types that follow the NUBC standard code set. ^[2] notes that MassHealth requires the use of standardized code sets on the UB-04 form.

Step-by-Step Claim Example

Consider a patient admitted to an acute care hospital for management of end-stage heart failure. The patient elects the Medicare hospice benefit and is discharged to receive hospice services at home. The hospital submits a UB-04 claim for the inpatient stay. In Field 17 (Patient Discharge Status), the provider enters code “50.” ^[1] Other fields are completed according to standard UB-04 instructions: Field 15 (Source of Admission) might be “1” (physician referral) or “4” (transfer from another hospital), and Field 16 (Condition Codes) may include code “42” (discharged to home hospice) if required by the payer. ^[2] provides general guidance on completing these fields. The claim also includes the patient’s demographic data (Fields 1–13), admission and discharge dates (Fields 12–13), and revenue codes with charges (Fields 42–47). The hospice agency’s Medicare number or National Provider Identifier (NPI) may be reported in Field 32 (Service Facility Location) if the hospice is the receiving provider. The claim is then submitted electronically or on paper if a waiver is obtained. ^[2] states that all claims must be submitted electronically unless the provider has an approved waiver. After submission, the payer processes the claim using the discharge status code to determine appropriate payment and to track hospice transitions.

Common Mistakes & Audit Red Flags

One frequent error is using code 01 (“Discharged to home or self-care”) when the patient is actually discharged to home hospice. ^[1] This can lead to claim denials or recoupment because the payer expects a hospice-related code. Another mistake is using code 50 when the patient is transferred to a hospice inpatient facility; code 51 should be used instead. ^[1] Auditors also look for inconsistent documentation: the medical record must clearly show that the patient elected hospice and that the discharge plan included home hospice services. If the record only mentions “discharged home” without hospice, code 50 may be considered unsupported. Additionally, providers sometimes fail to update the discharge status code when a patient initially discharged to home hospice later dies at home; code 40 (“Expired at home”) would be appropriate in that scenario. ^[1] Another red flag is using code 50 for a patient who is discharged to a hospice that is not Medicare-certified when the payer requires certification. While code 50 does not explicitly require certification in the Noridian list, code 51 specifies “certified,” so providers should verify payer-specific requirements. ^[1] Finally, incomplete UB-04 forms with missing or incorrect data in other fields can trigger audits even if the discharge code is correct. ^[2] emphasizes the importance of accurate completion of all required fields.

Related Codes/Fields

Code	Meaning (from Noridian)	Field	Notes
01	Discharged to home or self-care (routine discharge)	Field 17	No formal home care or hospice.
06	Discharged/transferred to home under care of organized home health service organization in anticipation of covered skilled care	Field 17	Skilled home health, not hospice.
50	Hospice – home	Field 17	Patient discharged to home hospice.
51	Hospice – medical facility (certified) providing hospice level of care	Field 17	Patient discharged to hospice inpatient facility.
40	Expired at home	Field 17	Used if patient dies at home after discharge.
41	Expired in a medical facility (e.g., hospital, SNF, ICF, or free-standing hospice)	Field 17	Used if patient dies in hospice facility.

All codes are from ^[1]. Field 17 is the Patient Discharge Status field on the UB-04 claim form. ^[2] confirms that the UB-04 uses standardized code sets for this field. Providers should refer to the full list of codes for other possible dispositions.

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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