Barriers to Discharge Coding System

100 Discharge Ready: Patients in the 100 series are discharge ready but for one of the following:

101 Appropriate placement does not exist.

102 AOR or Interstate Compact Issues

103 CORI – housing vendor waiting to receive

104 CORI- CORI precludes necessary housing subsidy

105 Not eligible for entitlements/insurance. Contingency funds needed

106 Immigration status issues

107 Not DMH eligible – needs DMR placement

108 Not DMH eligible – needs VA, DOC, etc.)

109 Not DMH eligible and homeless

110 Placement in process; residence identified, but not yet transitioning

111 Refusing all discharge

112 Refusing identified discharge option 

113 Refused by Nursing Home because of psychiatric/behavioral issues

114 Refused by Residential Program because pt will not attend day program

115 Refused by vendor/program because of risk issues

116 Referred for residential service -appropriate placement not yet identified

117 Transitioning to placement for discharge

118 Unable to obtain timely medication follow-up appt.

119 Waiting for identity documents

120 Waiting for housing inspection

121 Wait list for residential program

122 Waiting for housing subsidy

123 Wait list for day program/services

124 Needs or on Wait list for SNF or Rest Home

125 SORB Issues

126 disagreement between inpatient/outpatient teams

200 Medical Issues precluding discharge:

201 Medical condition (s) requiring intermittent nursing supervision (ex. IDDM)

202 Medical condition (s) requiring 24/7 nursing supervision/SNF

203 Unstable medical issues requiring specific, time limited treatment precluding discharge 

204 Unstable but resolvable medical conditions unable to be managed in community 

 
300 Forensic: 

301 Forensic evaluation in process (15b, 15e, 18a)

302 DA issues exist

303 Unresolved legal issues (would include open charges)

304 30-day letter submitted to DA

305 Section 17A in process

400 Guardian/family:

401 Family/Guardian refuses identified specific discharge

402 Family/Guardian refuses all discharge

403 Issues with guardian interface with team

500 Behavioral issues preventing discharge

501 self-injurious, e.g. swallowing, head banging, cutting

502 Lacking in life preserving skills

503 unwilling to participate in treatment/evaluations

504 regressive behaviors with no medical cause, e.g. incontinence, poor ADLs

505 AWA risk keeps pt. restricted

506 Active Eating disorder

507 High risk for unacceptable behaviors in community (wandering, violence, severe substance use, PSB, etc) due to primary psychiatric problems

508 High risk for unacceptable behaviors in community (wandering, violence, severe substance use, PSB, etc)       NOT due to primary psychiatric problems

 
600 Clinical instability: 

601 unable to participate in treatment due to acuity of psych illness/symptoms

602 aggression secondary to psychiatric symtomatology

603 Actively suicidal

604 Medication adjustment in process

605 improving, but not clinically ready for discharge

606 Guardianship issues limiting assess to treatment.

607 Cannot maintain stability long enough to consider discharge (in hospital or by history in community)

700 is about people who have stayed so long they are traumatized by the idea or the initiation of leaving

800 Specialized assessments: 

801 Requires MIPSB eval

802 Requires Fire setting eval

803 Other specialty assessments needed

804 Requires MFR for advancement of privs

805 Requires MFR for Discharge

806  Unresolved MFR issues

807  Unresolved Risk Reconciliation

900 Other