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