Case management notes document transfer to a skilled nursing facility, but the discharge disposition on the abstract still shows home. What should the facility coder do first?
Select an answer to reveal the explanation.
Short Explanation
Think of the discharge disposition like the last stop on a bus route—you cannot leave the rider at “home” when the trip sheet says SNF. When case management and the abstract disagree, chase the real discharge paperwork and fix the conflict before you lock the case.
Full Explanation
When case management notes document transfer to a skilled nursing facility but the discharge disposition on the abstract still shows home, the facility coder should first resolve the disposition conflict with the authoritative discharge documentation before finalizing the abstract. Disposition accuracy affects quality reporting and certain IPPS transfer-related payment policies for county hospitals. Leaving disposition as home because registration data always override case management notes fails when clinical discharge planning contradicts registration. Changing disposition to SNF transfer immediately without reviewing the discharge order or summary fails because the coder must verify the authoritative physician discharge documentation. Deleting the case management note so the abstract matches home fails integrity and may hide the true discharge plan. Exam caveat: reconcile conflicting disposition sources against discharge orders/summary before final abstract. Operational check: compare face sheet, discharge summary, orders, and case management notes on the municipal stay; correct disposition per policy; and notify registration if administrative files need update. Sample SNF-versus-home mismatches in civic coding audits.