Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: November 18, 2014

Program Area: Distributed Data Collection (DDC) for RA Including HCRP/EDGE Server

Question: What Discharge Status Code should issuers use for interim claims at a location other than a hospital?

Answer: Issuers do not need to modify the Discharge Status Code when submitting modified interim bills for a facility other than a hospital. If an enrollee is still in a facility, the interim bill would be submitted with an xx1 bill type and the discharge status would reflect the current status of the patient. This will not result in a reject. Upon such time as the enrollee is no longer in residence at a facility, the discharge status would be updated. For inpatient stays at a hospital, the Centers for Medicare & Medicaid Services (CMS) requires issuers to aggregate all interim bills into a final bill with the discharge status that applies at the end of the stay.

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