Tip of the week: Familiarize yourself with how CMS intends to treat the U POA indicator
HIM Connection, April 22, 2008
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Since POA indicators came on the scene in October 2007, providers have wondered how CMS will treat the U indicator (documentation insufficient), and whether it will not yield a higher DRG when it is the only complication/comorbidity (CC) or major CC (MCC) on the claim. CMS has stated in its 2009 IPPS proposed rule that it will treat the U the same as the N (not POA), but with several exceptions:
Although we are proposing not paying the CC/MCC MS-DRG for HACs coded with the "U" indicator, we do recognize there may be some exceptional circumstances under which payment might be made. Death, elopement (leaving against medical advice), and transfers out of a hospital may preclude making an informed determination of whether an HAC was present on admission.
Ensure that your coders are reporting U indicators on a minimal basis and that physicians understand the implications of this indicator.
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