Hospice care provided by a hospice program is one of the four post-acute settings that trigger the transfer rules.
A version of this article was first published March 15, 2021, by HCPro's Revenue Cycle Advisor, a sibling publication to HealthLeaders.
Q: When a patient is discharged from an acute care hospital to a hospice program, should this be billed as a discharge or a transfer?
A: A discharge will also be paid as a transfer when the patient is discharged from an IPPS hospital to one of several specific post-acute settings but only when the MS-DRG assigned to that discharge is a qualifying MS-DRG.
CMS identifies those MS-DRGs that are Qualifying MS-DRGs in the IPPS final rule for each fiscal year (FY). In FY 2021, 280 out of 767 total MS-DRGs are designated as Qualifying MS-DRGs in Table 5 in the FY 2021 IPPS Final Rule.
Hospice care provided by a hospice program is one of the four post-acute settings that trigger the transfer rules.
The hospital should report DSC 50 (Discharged/Transferred to Hospice – Routine or Continuous Home Care) or DSC 51 (Discharged/Transferred to Hospice – General Inpatient Care or Inpatient Respite), as appropriate.
For more information, see "Note from the instructor: Renewed OIG focus on IPPS transfers reported as discharges" by Judith Kares, JD.
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