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Previous Admit - Next Admit Allowed - 11221 / 11222


Next Admission Record Admission Reasons

A=Allow     N=Not Allow

Previous Admission Record
Admit Reason
New ESRD Patient (Dialysis)New ESRD Patient (Transplant)Transfer InRestartDialysis After Transplant FailedDialysis in Support of TransplantTransplant
New ESRD Patient (Dialysis)NNAANNA
New ESRD Patient (Transplant)NNNNAAA
Transfer InNNAANNA
RestartNNAANNA
Dialysis After Transplant FailedNNAANNA
Dialysis in Support of TransplantNNNNAAA
TransplantNNNNAAA




Test Scenario 1

11221

Invalid admit reason: An exact match patient was found and the admit reason selected is invalid based on the next admission record's admit reason (New ESRD Patient)

Org Patient ID1010866666

Baseline File Date


Baseline File Name

xx

Baseline Data Submitted

Previous Admission Record Reason Code = Restart

Change File Date


Change File Name

xx

Change File Data Submitted

Next Admission Reason = New ESRD Patient 

Expected Results

This combination of Previous Admission Record Reason and Next Admission Reason Code should trigger a 11221 error based on the Patient Admit Discharge Reason rules. 

Comments

PASS - An error was triggered.




Test Scenario 2

11222

Invalid admit reason: An exact match patient was found and the admit reason selected is invalid based on the previous admission record's admit reason (Dialysis After Transplant Failed).

Org Patient ID1010866666

Baseline File Date

3/3/2021

Baseline File Name

xx

Baseline Data Submitted

Previous Admission Record Reason Code = New ESRD Patient

Change File Date

3/5/2021

Change File Name

xx

Change File Data Submitted

Next Admission Reason = Dialysis After Transplant Failed

Expected Results

This combination of Previous Admission Record Reason and Next Admission Reason Code should trigger a 11222 error based on the Patient Admit Discharge Reason rules. 

Comments

PASS - An error was triggered.



Test Scenario 3

11222

Invalid admit reason: An exact match patient was found and the admit reason selected is invalid based on the previous admission record's admit reason (Dialysis After Transplant Failed).

Org Patient ID1010866666

Baseline File Date

3/3/2021

Baseline File Name

xx

Baseline Data Submitted

Previous Admission Record Reason Code = New ESRD Patient

Change File Date

3/5/2021

Change File Name

xx

Change File Data Submitted

Next Admission Reason = Transfer In

Expected Results

This combination of Previous Admission Record Reason and Next Admission Reason Code should successfully process.

Comments

PASS - No error was triggered.



Discharge Reasons = 11225


Admission Reasons

A=Allow     N=Not Allow

Previous Admission Record
Discharge Reason
New ESRD Patient (Dialysis)New ESRD Patient (Transplant)Transfer InRestartDialysis After Transplant FailedDialysis in Support of TransplantTransplant
AcuteAANNNNN
DeathNNNNNNN
DiscontinueNNNANNA
Lost to Follow UpNNAAAAA
Recover FunctionNNNANNA
InvoluntaryNNANNNA
OtherNNAANNA
Transplant in USNNNNAAA
Transplant Outside USNNNNAAA
TransferNNANNNN
Transplant FailedNNNNANA
System DischargeNNAAAAA




Test Scenario 4

11225

Invalid Admit Reason: An exact match patient was found and the Admit Reason selected is invalid based on the previous admission record's Discharge Reason  ({0}).

Org Patient ID66576789899

Baseline File Date

3/3/2021

Baseline File Name

xx

Baseline Data Submitted

Admit - Transfer In

Change File Date

3/5/2021

Change File Name

xx

Change File Data Submitted

Discharge - Lost to Follow Up

Expected Results

This combination of Previous Admission Record Reason and Admission Reason Code should successfully process.

Comments

PASS - No error was triggered.




Test Scenario 4

11225

Invalid admit reason: An exact match patient was found and the admit reason selected is invalid based on the previous admission record's discharge reason (Lost to Follow Up)

Org Patient ID66576789899

Baseline File Date

3/3/2021

Baseline File Name

xx

Baseline Data Submitted

Admit - New to ESRD

Change File Date

3/5/2021

Change File Name

xx

Change File Data Submitted

Discharge - Lost to Follow Up

Expected Results

This combination of Previous Admission Record Reason and Admission Reason Code should  trigger a 11225 error based on the Previous Admission Record's Discharge Reason rules.

Comments

PASS - An error was triggered.