Reimbursement Methodologies, Hit 115 02386600
Reimbursement Methodologies, HIT 115
02386600
POA indicators defined as Present on Admission variables, which are reported
on an inpatient claim, indicate the primary & secondary diagnosis, that were
present at the time the inpatient admission occurs. POA indicators are required
for all claims involving Medicare Inpatient admissions to general IPPS acute care
hospitals, or facilities that are subject to regulations mandating the collection of
POA indicator information. POA indicators are used when submitting claims to
denote the patients condition upon admission. POA indicators are also used
to differentiate upon admission diagnosis, versus hospital acquired diagnosis’s.
The POA indicators’ consist of the following characters:
Y= Diagnosis was present at the time of the inpatient admission
N = Diagnosis was not present at the time of the inpatient admission
U = Documentation insufficient to determine if the condition was present at the
time of the inpatient admission
W = Clinically undetermined. Provider unable to clinically determine whether the
condition was present at the time of the inpatient admission.
1 = Exempt from POA reporting
Z = End of data segment.
In my opinion, POA indicators are useful to inpatient coding because it lets the
coder know exactly what diagnosis was present at the time of the admission.
Nzingha A. Goode
21802861
Reimbursement Methodologies, HIT 115
02386600
(continued)
Once the coder knows which diagnosis was present at the time of admission,
the coder can assume all other diagnosis’s were hospital acquired conditions,
(HAC) & code the claim accordingly.
POA indicators are used for inpatient coding and if a POA indicator is not
appended to the claim, the claim will be denied.
Some examples of inpatient conditions that Medicare deems preventable are:
o Air Embolisms
o Falls
o Pressure Ulcers
o Vascular
02386600
POA indicators defined as Present on Admission variables, which are reported
on an inpatient claim, indicate the primary & secondary diagnosis, that were
present at the time the inpatient admission occurs. POA indicators are required
for all claims involving Medicare Inpatient admissions to general IPPS acute care
hospitals, or facilities that are subject to regulations mandating the collection of
POA indicator information. POA indicators are used when submitting claims to
denote the patients condition upon admission. POA indicators are also used
to differentiate upon admission diagnosis, versus hospital acquired diagnosis’s.
The POA indicators’ consist of the following characters:
Y= Diagnosis was present at the time of the inpatient admission
N = Diagnosis was not present at the time of the inpatient admission
U = Documentation insufficient to determine if the condition was present at the
time of the inpatient admission
W = Clinically undetermined. Provider unable to clinically determine whether the
condition was present at the time of the inpatient admission.
1 = Exempt from POA reporting
Z = End of data segment.
In my opinion, POA indicators are useful to inpatient coding because it lets the
coder know exactly what diagnosis was present at the time of the admission.
Nzingha A. Goode
21802861
Reimbursement Methodologies, HIT 115
02386600
(continued)
Once the coder knows which diagnosis was present at the time of admission,
the coder can assume all other diagnosis’s were hospital acquired conditions,
(HAC) & code the claim accordingly.
POA indicators are used for inpatient coding and if a POA indicator is not
appended to the claim, the claim will be denied.
Some examples of inpatient conditions that Medicare deems preventable are:
o Air Embolisms
o Falls
o Pressure Ulcers
o Vascular