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March 2019

Here’s our hospital transfer policy

We’d like to remind you of Blue Cross Blue Shield of Michigan’s policy on transferring a patient from one hospital to another. When patients are discharged or transferred to another hospital, please indicate the appropriate discharge disposition as follows:

  • 02 (Discharged or transferred to another short-term general hospital)
  • 07 (Left against medical advice or discontinued care)

For electronic claims, discharge disposition is reported in Loop 2300 CL1-103 of the 837I transaction. For paper claims, use form locator 17 (patient discharge status) of the UB-04. The transferring hospital should receive full payment only when the patient’s length of stay meets or exceeds the maximum number of days allowed under the diagnosis-related group assigned to the admission.

If a patient is transferred to a second hospital before using all days allowed at the first hospital, the transferring hospital should receive only a per diem payment based on the length of stay.

Blue Cross reviews paid claims to identify patients who were discharged or transferred to another acute care facility. If we identify claims that should have been billed as transfers, we’ll adjust your payment.

For multiple transfers, refer to the article in the January 2010 Record.

No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2018 American Medical Association. All rights reserved.