Edit 00655

Discharge Date is different from Statement Thru Date

HIPAA Claim Adjustment Reason Code: 16
    Remark Code: N50
HIPAA Healthcare Claim Status Code: 190
    Entity Identifier Code: N/A

Potential Causes:
The Discharge Date on the claim is different than the Statement thru Date and the Patient Status Code (Discharge Status Code) is indicating a Discharge or Transfer occurred on the Thru Date of Service. If a Discharge/Transfer occurred on the Thru Date of Service, the Discharge Date and the Thru Date of Service must be the same date.

Solution:
Check the Discharge Date, Thru Date of Service and the Patient Status Code (Discharge Status Code) and make necessary correction. Enter the data in the loop and the segment provided, and resubmit.

Please note: Most Patient Status codes will be reported in Loop 2300, segment CL1 Institutional Claim Code. There are a few Patient Status codes that will be reported as Revenue Codes (Loop 2400, segment SV2, Institutional Service Line), or Occurrence Span Codes (Loop 2300, segment HI, Occurrence Span Information). In addition, there are several NYS Medicaid codes that have no direct map to the HIPAA values and will no longer be necessary. Please refer to the 837 Institutional Supplemental Guide located on this website (www.nyhipaadesk.com).

Discharge Date: Please use Loop 2300, HI segment (Occurrence Information), using value 42 – Discharge Date. Use this code to report the discharge date. The discharge date has been reported as a stand-alone field in past formats. This is only required when billing for Inpatient hospital stays. For further information please refer to the 837 Institutional Supplemental Companion Guide on this site (www.nyhipaadesk.com).