UB04 Patient Discharge Status Code 90: Discharged/transferred to an inpatient rehabilitation facility (IRF) including rehabilitation distinct part units of a hospital with a planned acute care hospital readmission

Overview

Patient Discharge Status Code 90 is defined as “Discharged/transferred to an inpatient rehabilitation facility (IRF) including rehabilitation distinct part units of a hospital with a planned acute care hospital inpatient readmission.” ^[1] This code became effective October 1, 2013. ^[1] It is used on the UB-04 claim form to indicate that a patient was discharged to an inpatient rehabilitation facility (IRF) and that the clinical team has already planned a future readmission to an acute care hospital for a specific procedure or treatment. ^[1] This code differs from code 62, which indicates discharge/transfer to an IRF without a planned acute care readmission. ^[1] The MassHealth UB-04 Billing Guide provides general instructions for completing the UB-04 form and emphasizes that providers must use the correct code sets when reporting patient status. ^[2] Hospitals and other billing entities must be aware that code 90 conveys both a transfer to an IRF and a planned acute care readmission. ^[1]

When to Use

Use code 90 only when the patient is discharged or transferred to an inpatient rehabilitation facility (IRF) or a rehabilitation distinct part unit of a hospital, AND there is a documented plan for a future acute care hospital readmission. ^[1] The code is effective for discharges occurring on or after October 1, 2013. ^[1] If the planned acute care readmission is not part of the discharge plan, code 62 should be used instead. ^[1]

Step-by-Step Claim Example

A patient is admitted to an acute care hospital for hip replacement surgery. After the surgery and a brief postoperative stay, the patient is medically stable but requires intensive rehabilitation. The discharging physician documents that the patient will be transferred to an inpatient rehabilitation facility (IRF) for 10 days of therapy, and then will return to the same acute care hospital for a planned second-stage procedure.

1. On the UB-04 claim form, the provider completes the Patient Discharge Status field (Form Locator 17) with code 90. ^[1]
2. The discharging hospital enters the IRF’s provider number in Form Locator 28 (Condition Code) or other appropriate transfer fields as required by the payer. ^[2]
3. The claim is submitted with the discharge date and all relevant diagnosis/procedure codes. ^[2]
4. The IRF later submits its own claim using patient admission source code indicating transfer from acute hospital (e.g., code 1). ^[2]
5. When the planned acute care readmission occurs, the hospital submits a new inpatient claim, using admission source code to reflect readmission from an IRF. ^[2]

This example follows the definitions provided in the Noridian list: the discharge is to an IRF (including a distinct part unit) and the acute care readmission is planned. ^[1] Using code 90 instead of 62 signals the planned nature of the readmission. ^[1]

Common Mistakes & Audit Red Flags

• Using code 90 when there is no planned acute care readmission: Code 90 is specifically for transfers to an IRF with a planned acute care hospital readmission. Using it for any other IRF transfer will be flagged as incorrect. ^[1]
• Confusing code 90 with code 62: Code 62 means “Discharged/transferred to an inpatient rehabilitation facility (IRF)… without a planned acute care readmission.” ^[1] Using code 62 when a readmission is planned (or code 90 when it is not) can lead to payment recoupment or denial.
• Missing documentation of planned readmission: Payers may audit to confirm that a planned acute care readmission was indeed scheduled at the time of discharge. Providers should retain clinical documentation showing the plan. ^[2]
• Inconsistent use across transfers: If the IRF admission source code or the subsequent acute care claim does not align with code 90, auditors may question continuity of care. ^[2]
• Using code 90 for non-IRF transfers: Code 90 is valid only for transfers to an inpatient rehabilitation facility or rehabilitation distinct part unit. It should not be used for skilled nursing facilities, long-term care hospitals, or other settings. ^[1]

Related Codes/Fields

The following table lists discharge status codes on the UB-04 that are related to code 90, as defined in the Noridian list. ^[1]

Code	Meaning	Relationship to Code 90
62	Discharged/transferred to an IRF (including rehabilitation distinct part units) without planned acute care readmission	This is the non‑planned counterpart of code 90. Use when no future acute readmission is scheduled.
63	Discharged/transferred to a Medicare certified long‑term care hospital (LTCH)	Used for LTCH transfers; not an IRF.
65	Discharged/transferred to a psychiatric hospital or psychiatric distinct part unit	Different facility type; do not use code 90 for psychiatric transfers.
66	Discharged/transferred to a critical access hospital (CAH)	Transfer to CAH; not an IRF.
91	Discharged/transferred to a LTCH with planned acute care hospital readmission	Analogous planned‑readmission code for LTCH.
92	Discharged/transferred to a nursing facility certified under Medicaid (not Medicare) with planned acute care readmission	Planned‑readmission code for Medicaid‑only nursing facility.
93	Discharged/transferred to a psychiatric hospital/unit with planned acute care readmission	Planned‑readmission code for psychiatric settings.
94	Discharged/transferred to a CAH with planned acute care readmission	Planned‑readmission code for CAH.

The UB-04 field where these codes are entered is Form Locator 17 (Patient Discharge Status). ^[2] Accurate use of related codes helps ensure claims are processed correctly and that the planned readmission logic is applied consistently. ^[1]

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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