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Back  RFI # 1781: Patient Status CodeCL103

Formal vs. Informal Help Informal Formal

Submitter

Deb McCachern

Description

This pertains to the 278 Request (005010X217).

The NUBC code values (Code Source 239: Patient Discharge Status) used for CL103 all presume that the patient has already been admitted.

However, an Admission Review transaction often is used for precertification of an upcoming admission, so the NUBC Patient Discharge Status codes available for CL103 would not apply.

This element appears to be required "when health care services review is for inpatient services," which whould always be the case when UM01=AR.

What are the appropriate code values to be sent in CL103 for an admission precertification?

Submitter Assigned Keywords

CL103 Patient Discharge Status

Response

CL103 is required when the health care services review is for inpatient service, which includes admission requests. Code source 239 is an external code list developed by the NUBC. To add code values to this list, a request would have to be made to the NUBC. Please note that the use of this segment in the 5010 version of the implementation guide was a concern and is marked as "Not Used" in the next version of the implementation guide.
Submission 4/18/2013
Status Date 6/3/2013
Status F - Final
Primary References
Document 005010X217
Section2
Set ID278
Loop2000E
Segment IDCL1
Element PositionCL
Industry NamePatient Status Code