Understanding CMS Condition Codes 42, 43
Understanding CMS Condition Codes 42, 43
The Centers for Medicare & Medicaid Services (CMS), of Baltimore, requires Condition Code 42 to be used when a hospital patient is discharged to home health services. The home health treatment plan is unrelated to the inpatient stay.
However, Condition Code 43 is used when the hospital patient is discharged with home care services that do not begin until after the third day post-discharge.
Providers use both codes with the discharge disposition code 06, which is for patients who are discharged or transferred to home under care of organized home health service organization.
The Centers for Medicare & Medicaid Services (CMS), of Baltimore, requires Condition Code 42 to be used when a hospital patient is discharged to home health services. The home health treatment plan is unrelated to the inpatient stay.Subscribe Now for Access
You have reached your article limit for the month. We hope you found our articles both enjoyable and insightful. For information on new subscriptions, product trials, alternative billing arrangements or group and site discounts please call 800-688-2421. We look forward to having you as a long-term member of the Relias Media community.