UB04 Patient Discharge Status Code 93: Discharged/transferred to a psychiatric hospital or psychiatric distinct part unit of a hospital with a planned acute care hospital readmission

Overview

Patient Discharge Status Code 93 indicates that a patient was discharged or transferred to a psychiatric hospital or a psychiatric distinct part unit of a hospital, with a planned acute care hospital inpatient readmission. This code became effective on October 1, 2013. ^[1]

The code is part of a series of discharge status codes (81-94) that specifically denote a planned acute care hospital readmission in combination with the discharge destination. Code 93 specifically combines the psychiatric facility transfer (similar to code 65) with the planned readmission designation. ^[1]

This code is used on the UB-04 claim form in Form Locator 17 (Patient Discharge Status). It is distinct from code 65, which indicates a transfer to a psychiatric hospital or psychiatric distinct part unit without a planned acute care readmission. ^[1]

When to Use

Use code 93 when a patient is discharged from an acute care hospital and transferred directly to a psychiatric hospital or a psychiatric distinct part unit of a hospital, AND there is a documented, planned acute care hospital inpatient readmission. ^[1]

This code applies specifically to transfers to psychiatric hospitals or distinct part units that provide psychiatric services. A "psychiatric distinct part unit" refers to a separately certified unit within a general hospital that provides inpatient psychiatric care. ^[1]

The planned readmission must be for acute care services, not for psychiatric care. The readmission must be scheduled or planned at the time of discharge to the psychiatric facility. If there is no planned acute care readmission, use code 65 instead. ^[1]

Do not use this code if the patient is being transferred for psychiatric care only without a planned acute care readmission. Also do not use it if the patient is being discharged to a psychiatric facility but the acute care readmission is not planned or documented at the time of discharge. ^[1]

Step-by-Step Claim Example

Scenario: A 45-year-old patient is admitted to General Hospital for treatment of pneumonia. During the admission, the patient also requires stabilization for acute psychosis. After medical stabilization, the patient is transferred to the psychiatric distinct part unit of the same hospital. The medical team documents a planned readmission to the acute care unit in 10 days for a scheduled surgical procedure related to the pneumonia complications.

Step 1: Complete Form Locator 17 (Patient Discharge Status) on the UB-04 claim form. Enter code "93" in this field. ^[2]

Step 2: In Form Locator 12 (Patient Discharge Hour), enter the time of discharge from the acute care unit. ^[2]

Step 3: In Form Locator 13 (Patient Discharge Status), ensure the code 93 is clearly written or printed. ^[2]

Step 4: Complete Form Locator 14 (Type of Admission) with the appropriate code (1 for emergency, 2 for urgent, 3 for elective). ^[2]

Step 5: In Form Locator 15 (Source of Admission), indicate the source of admission (e.g., 1 for physician referral, 2 for clinic referral). ^[2]

Step 6: Complete all other required fields on the UB-04 form including patient demographics, insurance information, and revenue codes. ^[2]

Step 7: Submit the claim according to MassHealth requirements. Note that MassHealth requires electronic submission unless a waiver has been approved. ^[2]

Common Mistakes & Audit Red Flags

Mistake 1: Using code 93 when there is no planned acute care readmission. This is the most common error. If the patient is transferred to a psychiatric facility without a documented, planned acute care readmission, use code 65 instead. ^[1]

Mistake 2: Using code 93 for transfers to non-psychiatric facilities. Code 93 is specifically for psychiatric hospitals or psychiatric distinct part units. Do not use it for transfers to general hospitals, rehabilitation facilities, or skilled nursing facilities. ^[1]

Mistake 3: Confusing code 93 with code 65. Code 65 indicates a transfer to a psychiatric hospital or psychiatric distinct part unit WITHOUT a planned acute care readmission. Code 93 includes the planned readmission component. ^[1]

Audit Red Flag: Claims with code 93 that lack documentation of the planned acute care readmission in the medical record. Auditors will look for evidence that the readmission was planned at the time of discharge. ^[1]

Audit Red Flag: Using code 93 when the patient is discharged to a psychiatric facility that is not a distinct part unit of a hospital. Code 93 only applies to psychiatric hospitals or distinct part units, not to general psychiatric units within a hospital. ^[1]

Related Codes/Fields

Code	Description	Relationship to Code 93
65	Discharged/transferred to a psychiatric hospital or psychiatric distinct part unit of a hospital	Similar destination but WITHOUT planned acute care readmission
81	Discharged to home or self-care with planned acute care readmission	Same planned readmission concept but different destination
82	Discharged/transferred to short-term general hospital with planned acute care readmission	Same planned readmission concept but different destination
90	Discharged/transferred to IRF with planned acute care readmission	Same planned readmission concept but different destination
01	Discharged to home or self-care	No planned readmission, no psychiatric transfer
02	Discharged/transferred to short-term general hospital	No planned readmission, no psychiatric transfer
Form Locator 17	Patient Discharge Status	Field where code 93 is entered on UB-04
Form Locator 12	Patient Discharge Hour	Related field for discharge timing
Form Locator 14	Type of Admission	Related field for admission type

^[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