Patient discharge status · UB-04 FL 17
Patient status 20: expired.
Patient discharge status code 20 means the patient expired. It goes in UB-04 form locator 17, which shows the patient's status as of the "Through" date of the billing period. CMS's inpatient rehabilitation facility rules also require it on claims paid under the expired-case groups.
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What CMS says about the field and code 20
Chapter 25, section 75.2 of the Medicare Claims Processing Manual says FL 17, Patient Discharge Status, is required for inpatient, SNF, hospice, home health agency and outpatient hospital services, and that it indicates the patient's discharge status as of the "Through" date of the billing period (FL 6). The same section says the codes used for Medicare claims are available from Medicare contractors and from the NUBC.
Chapter 3, section 140.3.1 prints the code as "20 (Expired)": for inpatient rehabilitation facility claims, if the HIPPS rate code is 5101, 5102, 5103 or 5104, the patient status must be 20 (Expired).
The IRF groups behind that rule
Chapter 3, section 140.2.4 explains that four case-mix groups exist for cases that expire. CMG 5101 is for short-stay orthopedic expired cases (length of stay more than 3 but not more than 13 days). CMG 5102 is for orthopedic expired cases with a stay of 14 days or more. CMG 5103 is for short-stay non-orthopedic expired cases (more than 3 but not more than 15 days). CMG 5104 is for non-orthopedic expired cases with a stay of 16 days or more. Cases that expire with a stay of 3 days or less are classified to CMG 5001.
What to check
- Make sure code 20 matches the patient's status as of the claim's "Through" date.
- On IRF claims with HIPPS rate codes 5101 to 5104, a status other than 20 is an error under the manual.
- Do not use 20 on an interim bill for a patient who is still in the facility; see status 30 for that case.
Worked example (hypothetical)
An inpatient rehabilitation patient with a non-orthopedic condition dies on day 18. The case is grouped to CMG 5104 (non-orthopedic expired, 16 days or more) and the claim carries HIPPS rate code 5104. The billing edit expects patient status 20.
What this page does not do
The NUBC owns and licenses the full patient discharge status code set. CMS says in chapter 25 that the codes are available from Medicare contractors and from the NUBC Official UB-04 Data Specifications Manual, so this page uses only the wording CMS itself prints in its manuals and does not reproduce the NUBC table.
Other codes in this set
Patient status 30, Patient status 63.
Sources
- CMS: Medicare Claims Processing Manual, Chapter 25 (Completing and Processing the CMS-1450 Data Set), section 75.2, FL 17 — says the patient status codes are available from Medicare contractors and from the NUBC (retrieved 2026-11-02)
- CMS: Medicare Claims Processing Manual, Chapter 3 (Inpatient Hospital Billing), Rev. 14000, issued 10-08-26 — read 2026-11-02
The CMS manual passages above were read on November 2, 2026. Payers and CMS revise code lists, contracts and policies, so confirm anything that affects a claim or a payment with your Medicare Administrative Contractor.
Frequently asked questions
Where does code 20 go on the UB-04?
In form locator 17, Patient Discharge Status, which shows the status as of the "Through" date of the billing period.
When does CMS require code 20 on an IRF claim?
Chapter 3 says that if the HIPPS rate code is 5101, 5102, 5103 or 5104, the patient status must be 20 (Expired).
Is this the full list of patient status codes?
No. The NUBC licenses the full code set. CMS says the codes are available from Medicare contractors and from the NUBC.
Not legal, billing or medical advice
This page explains published CMS code definitions and runs a lookup in your browser. It cannot see your claim, your contract or any payer's policy. Confirm with your Medicare Administrative Contractor before you resubmit, appeal or bill a patient.