Claim HHA Referral Code

SAS Name
CLM_HHA_RFRL_CD

Effective with Version 'I', the code used to identify the means by which the beneficiary was referred for Home Health services. 

Comments

The use of this code will permit the agency to send a new RAP allowing all claims to be accepted by Medicare. (eff. 10/00)

Beginning 10/1/00, this field was populated with data. Claims processed prior to 10/1/00 contained spaces in this field. 

Source: NCH

REFER TO :
HHA_RFRL_CD_LIM
Code Code value
1 Physician referral - The patient was admitted upon the recommendation of a personal physician.
2 Clinic referral - The patient was admitted upon the recommendation of this facility's clinic physician.
3 HMO referral - The patient was admitted upon the recommendation of an health maintenance organization (HMO) physician.
4 Transfer from hospital - The patient was admitted as an inpatient transfer from an acute care facility.
5 Transfer from a skilled nursing facility (SNF) - The patient was admitted as an inpatient transfer from a SNF.
6 Transfer from another health care facility - The patient was admitted as a transfer from a health care facility other than an acute care facility or SNF.
7 Emergency room - The patient was admitted upon the recommendation of this facility's emergency room physician.
8 Court/law enforcement - The patient was admitted upon the direction of a court of law or upon the request of a law enforcement agency's representative.
9 Information not available - The means by which the patient was admitted is not known.
A Transfer from a Critical Access Hospital - patient was admitted/referred to this facility as a transfer from a Critical Access Hospital.
B Transfer from another HHA - Beneficiaries are permitted to transfer from one HHA to another unrelated HHA under HH PPS. (eff. 10/00)
C Readmission to same HHA - If a beneficiary is discharged from an HHA and then readmitted within the original 60-day episode, the original episode must be closed early and a new one created. NOTE: the use of this code will permit the agency to send a new RAP allowing all claims to be accepted by Medicare. (eff. 10/00)
D Unknown/invalid code.