Present on Admission (POA) Indicators and Reporting Flashcards
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Read the first 7 Present on Admission (POA) Indicators and Reporting flashcards as text
What does the POA indicator 'Y' represent in inpatient coding?
Answer: The condition was present at the time of inpatient admission
POA indicator 'Y' means the condition was present at the time of the order for inpatient admission.
Which federal legislation mandated hospitals to report Present on Admission (POA) indicators for Medicare inpatient claims?
Answer: The Deficit Reduction Act of 2005
The Deficit Reduction Act of 2005 directed CMS to identify hospital-acquired conditions and required POA indicator reporting to distinguish them from conditions present at admission.
What POA indicator is assigned when clinical documentation is insufficient to determine if a condition was present at the time of inpatient admission?
Answer: U
POA indicator 'U' is assigned when documentation is insufficient to determine whether the condition was present on admission.
A patient develops a urinary tract infection on post-operative day 3, with no evidence of infection at admission. Which POA indicator applies?
Answer: N
POA indicator 'N' is assigned when a condition was NOT present at the time of inpatient admission, such as an infection that developed during the hospital stay.
Hospital-Acquired Conditions (HACs) that are NOT present on admission may result in which financial consequence under Medicare?
Answer: Loss of additional payment — CMS pays as if the secondary diagnosis were not present
When a designated HAC is not present on admission, CMS does not pay the higher MS-DRG rate associated with that complication or comorbidity, reducing hospital reimbursement.
Which of the following code categories is EXEMPT from POA indicator reporting?
Answer: External cause codes (V, W, X, Y codes)
External cause codes (V, W, X, Y codes) are among the categories exempt from POA reporting, as designated in CMS guidelines.
What is the primary purpose of the POA reporting requirement for inpatient hospital claims?
Answer: To distinguish conditions present at admission from those that are hospital-acquired
The POA requirement enables identification of hospital-acquired conditions by distinguishing conditions present at admission from those that developed during the hospital stay.