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This document outlines the requirements set by Blue Cross and Blue Shield of Kansas for reporting Present on Admission (POA) indicators for inpatient claims, including applicable coding and exemptions.
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How to fill out present on admission poa
How to fill out Present on Admission (POA) Indicators
01
Begin by gathering patient admission data and relevant medical history.
02
Identify and document the patient's medical conditions at the time of admission.
03
Use standardized coding systems (such as ICD-10) to classify each condition.
04
For each condition, indicate if it was present on admission or acquired during the hospital stay.
05
Review the indicators for accuracy and completeness before final submission.
Who needs Present on Admission (POA) Indicators?
01
Healthcare facilities for accurate billing and reimbursement.
02
Medical coders responsible for coding diagnoses.
03
Insurance companies for claims processing.
04
Regulatory bodies for quality reporting and compliance.
05
Healthcare providers to improve patient care assessments.
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What are present on admission POA indicators?
The Present on Admission (POA) indicator is a data element on the hospital administrative record that is associated with each diagnosis field and indicates whether the condition was present at hospital admission (a comorbidity) or whether it arose during the hospitalization stay (a complication).
What are present on admission indicators?
The Present on Admission (POA) indicator is a data element on the hospital administrative record that is associated with each diagnosis field and indicates whether the condition was present at hospital admission (a comorbidity) or whether it arose during the hospitalization stay (a complication).
What is the present on admission indicator on the UB04?
On the UB-04, the POA indicator is the eighth digit of Field Locator (FL) 67, Principal Diagnosis and the eighth digit of each of the Secondary Diagnosis fields, FL 67 A–Q.
What is a poa indicator?
Present on Admission (POA) Indicators POA is defined as present at the time the order for inpatient admission occurs – conditions that develop during an outpatient encounter, including emergency department, observation, or outpatient surgery, are considered as POA.
What is the POA indicator on a UB04?
On the UB-04, the POA indicator is the eighth digit of Field Locator (FL) 67, Principal Diagnosis and the eighth digit of each of the Secondary Diagnosis fields, FL 67 A–Q. You should report the applicable POA indicator (Y, N, U, or W) for the principal diagnosis and any secondary diagnoses as the eighth digit.
What does the POA indicator E indicates?
The E codes are used to identify external causes of injury, poisoning, or other adverse events. The POA indicators for the regular (non-E code diagnoses) are stored in the variables POA_DGNS_1_IND_CD–POA_DGNS_25_IND_CD. Unreported/not used — exempt from POA reporting. This code is equivalent to a blank on the UB04.
How to determine present on admission?
Present on admission is defined as a condition that is present at the time the order for inpatient admission occurs. That means that conditions that develop during any outpatient encounter “including in the emergency department or during observation or outpatient surgery “are considered to be present on admission.
Does the principal diagnosis have to be present on admission?
Consider what is the main reason the patient could not go home or the main problem that “bought the bed.” Remember: the diagnosis must be present on admission (POA) to be considered the principal diagnosis.
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What is Present on Admission (POA) Indicators?
Present on Admission (POA) Indicators are markers used to identify whether a condition was present at the time of a patient's admission to a healthcare facility.
Who is required to file Present on Admission (POA) Indicators?
Healthcare providers and facilities that submit claims for inpatient hospital stays are required to file Present on Admission (POA) Indicators.
How to fill out Present on Admission (POA) Indicators?
To fill out POA Indicators, healthcare providers must review the patient's medical history and determine whether each condition was present at the time of admission, then use the appropriate codes to indicate this on documentation.
What is the purpose of Present on Admission (POA) Indicators?
The purpose of POA Indicators is to improve the accuracy of hospital coding, ensure appropriate reimbursement, and enhance quality reporting by distinguishing between conditions that were present prior to admission and those that developed during the hospital stay.
What information must be reported on Present on Admission (POA) Indicators?
Healthcare providers must report whether each diagnosis was present at the time of admission, using specific POA codes: 'Y' for yes, 'N' for no, 'U' for unknown, 'W' for clinician's documentation unable to determine, and '1' for exempt.
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