CIC Present on Admission (POA) Indicators and Reporting

Question 1

What does the POA indicator 'Y' represent in inpatient coding?

Accepted Answer

The condition was present at the time of inpatient admission

Answer

The condition developed after admission

Answer

The documentation is insufficient to determine POA status

Answer

The condition is exempt from POA reporting

Question 2

Which federal legislation mandated hospitals to report Present on Admission (POA) indicators for Medicare inpatient claims?

Accepted Answer

The Deficit Reduction Act of 2005

Answer

The Health Insurance Portability and Accountability Act (HIPAA) of 1996

Answer

The Affordable Care Act of 2010

Answer

The Medicare Modernization Act of 2003

Question 3

What POA indicator is assigned when clinical documentation is insufficient to determine if a condition was present at the time of inpatient admission?

Accepted Answer

U

Answer

Y

Answer

N

Answer

W

Question 4

A patient develops a urinary tract infection on post-operative day 3, with no evidence of infection at admission. Which POA indicator applies?

Accepted Answer

N

Answer

Y

Answer

U

Answer

W

Question 5

Hospital-Acquired Conditions (HACs) that are NOT present on admission may result in which financial consequence under Medicare?

Accepted Answer

Loss of additional payment — CMS pays as if the secondary diagnosis were not present

Answer

Increased MS-DRG reimbursement for the additional complexity

Answer

No change in reimbursement regardless of POA status

Answer

Automatic denial of the entire inpatient claim

Question 6

Which of the following code categories is EXEMPT from POA indicator reporting?

Accepted Answer

External cause codes (V, W, X, Y codes)

Answer

ICD-10-CM codes for chronic conditions such as hypertension

Answer

ICD-10-CM codes for acute myocardial infarction

Answer

ICD-10-CM codes for infectious diseases

Question 7

What is the primary purpose of the POA reporting requirement for inpatient hospital claims?

Accepted Answer

To distinguish conditions present at admission from those that are hospital-acquired

Answer

To increase hospital reimbursement through better documentation capture

Answer

To simplify the MS-DRG assignment process for inpatient coders

Answer

To eliminate the physician query process in inpatient facilities