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
Which POA indicator is assigned when the provider is clinically unable to determine whether a condition was present on admission or not?
Answer: W
POA indicator 'W' is used when clinical documentation indicates the provider cannot clinically determine whether the condition was present on admission.
A patient is admitted for elective hip replacement. On post-operative day 2, a catheter-associated urinary tract infection (CAUTI) is diagnosed. What POA indicator applies to the CAUTI?
Answer: N — not present at admission
Since the CAUTI developed after admission (post-op day 2), it was NOT present at admission, making POA indicator 'N' appropriate.
Which of the following conditions is included in CMS's list of Hospital-Acquired Conditions (HACs)?
Answer: Surgical site infection following certain orthopedic procedures when not POA
Surgical site infections following certain procedures are on CMS's HAC list and affect reimbursement when assigned a POA indicator of 'N.'
POA indicator reporting is required on which type of claims?
Answer: Inpatient prospective payment system (IPPS) hospital claims
POA indicators are required on inpatient hospital claims subject to the IPPS, primarily Medicare Part A inpatient admissions.
A patient is admitted via the emergency department following a motor vehicle accident. The external cause code for the accident would receive which POA indicator?
Answer: 1 — exempt from POA reporting
External cause codes (V, W, X, Y codes) are exempt from POA reporting and receive the indicator '1.'
A patient is admitted with Type 2 diabetes. Chronic kidney disease Stage 3 is also documented, but the provider does not state whether it predates admission. What POA indicator is most appropriate while awaiting clarification?
Answer: U — insufficient documentation to determine POA status
When documentation is insufficient to determine whether a condition was present at admission, POA indicator 'U' is assigned, which may prompt a physician query.
Under the MS-DRG system, what happens to DRG payment when a designated HAC is assigned a POA indicator of 'N'?
Answer: CMS pays the MS-DRG as if the secondary diagnosis (HAC) were not present, reducing payment
When a HAC is not present on admission, CMS pays the lower MS-DRG that would have been assigned without that secondary diagnosis, removing the CC/MCC financial benefit.