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Back  RFI # 1090: Definition of Episode of Care

Formal vs. Informal Help Informal Formal


Chris Baker


Section 1.5 of the guide defines a patient event as "the service or group of services associated with a single episode of care." What is considered an "episode of care"?

For example, can an episode of care include an admission and a referral which are combined in the 278?


The 278 guide does not contain the definition for episode of care, however the following link provides an industry definition.


Yes, an episode of care can include an admission and a referral. For additional examples, please reference the following sections of the 005010X217 278 guide:

1.5, 1.11.1 and 1.12.3.
Submission 6/28/2010
Status Date 7/30/2010
Status F - Final
Primary References
Document 005010X217
Set ID278