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Note from Hugh

Medicare Weekly Update, May 15, 2007

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As discussed below, CMS issued a new transmittal last week relating to the requirement that hospitals begin reporting "present on admission" (POA) codes. It is easy to get confused about the various dates relating to the implementation of the POA code reporting requirement. Here is a summary:

Discharges on or after October 1, 2007: Hospitals (other than critical access hospitals, Maryland waiver hospitals, long term care hospitals, cancer hospitals and children's hospitals) are required by federal law to begin reporting POA codes on inpatient claims. However, CMS will not use the POA codes for claims processing.

Discharges on or after January 1, 2008: CMS will begin using the POA codes for claims processing. However, claims will continue to be processed even if a valid POA code is not reported for each diagnosis. The remitance advice will notify hospitals if an invalid POA code was reported.

Beginning April 1, 2008 (Note: it is not clear whether this is a discharge date or a claim processing date): Claims without a valid POA code for each diagnosis on the claim will be returned to the hospital for correction.

The transittal also includes a summary of "general reporting requirements" for POA codes and a list of "CMS reporting options and definitions." Please click on the link below to view the full transmittal.

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